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Toxoplasmosis Serologic Testing Algorithm

Toxoplasmosis serologic testing is performed on pregnant women to screen for Toxoplasma gondii antibodies. Based on the results of IgG and IgM testing, patients are categorized as having a chronic infection acquired over 1 year ago, no current infection, possible early acute infection, or indeterminate results. A follow up test in 3 weeks helps determine the likelihood and timing of infection. Patients with possible recent infections may receive additional testing and treatment depending on the risk to the fetus.

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Hanny Prasetiana Yurianti
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35 views

Toxoplasmosis Serologic Testing Algorithm

Toxoplasmosis serologic testing is performed on pregnant women to screen for Toxoplasma gondii antibodies. Based on the results of IgG and IgM testing, patients are categorized as having a chronic infection acquired over 1 year ago, no current infection, possible early acute infection, or indeterminate results. A follow up test in 3 weeks helps determine the likelihood and timing of infection. Patients with possible recent infections may receive additional testing and treatment depending on the risk to the fetus.

Uploaded by

Hanny Prasetiana Yurianti
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Toxoplasmosis Serologic Testing for Pregnant Women

(modified from algorithm Montoya, 2008)


Click here for topics associated with this algorithm

SCREEN
Toxoplasma gondii Antibodies, IgG and
IgM

IgG+, IgM-

Infected with
Toxoplasma for
>1 year
No further
action

IgG-, IgM-

No current
infection; retest at
18 wks gestation
and again near
term
Avoid exposure to
parasite through
o Raw infected
meat
o Oocysts from
soil
contaminated
with cat feces

IgG?, IgM-

IgG-, IgM?

IgG-, IgM+

Possible early
acute infection or
false-positive result

Possible early
acute infection or
false-positive result

Indeterminate

IgG?, IgM?
Indeterminate

IgG+, IgM+

IgG+, IgM?
Most likely:
Chronic Infection
False positive
reaction
Early acute

IgG?, IgM+
Possible acute
infection

Most likely:
Chronic
infection <12
months
False positive
reaction
Early acute

Obtain follow-up specimen 3 weeks later; use as a comparator with first test

Same result
(IgG-, IgM?)
Patient most
likely not
infected

Same result
(IgG-, IgM+)
Most likely
false positive
reaction

Same result
(IgG?, IgM-)
Patient most
likely not
infected

Same result
(IgG?, IgM?)
Patient most
likely not
infected

Send to reference laboratory if


confirmation is required*

Results Key
? = equivocal
- = negative
+ = positive
* = Toxoplasma Serology Laboratory at Palo Alto
Medical Foundation (reference lab for CDC)

References
Montoya JG, Remington JS. Management of Toxoplasma gondii infection during
pregnancy. Clin Infect Dis. 2008 Aug 15;47(4):554-66.

2006 ARUP Laboratories. All Rights Reserved. Revised 07/28/2014

Same result
(IgG+, IgM?)
Send both
specimens to
reference
laboratory*

Same result
(IgG?, IgM+) or if
IgG becomes +
Send both
specimens to
reference
laboratory*

Toxoplasma Serologic Profile (TSP)


(available only at reference lab*) +/avidity testing

TSP consistent with recently acquired infection


Treat
Recommend Toxoplasma gondii by PCR on
amniotic fluid at 18 weeks gestation

Negative
Continue treatment until term
Thorough evaluation of
newborn

Send to
reference
laboratory

Positive

If TSP
consistent with
infection
acquired in the
distant past, no
further action
necessary

Discuss options:
Treatment
Therapeutic abortion
www.arupconsult.com

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