Patogénesis de la infección y Manejo Preconcepcional de la infección por T. gondi.

[Pathogenesis of Infection and Preconception Management of T. gondii Infection.]


    Ameth Hawkins Villarreal1
Publicado: 2023-09-10



La toxoplasmosis es una infección provocada por el parásito unicelular Toxoplasma gondii. Según las encuestas serológicas de la Tercera Encuesta Nacional de Salud y Nutrición en los Estados Unidos, alrededor del 23% de los adolescentes y adultos tienen signos serológicos de infección por T. gondii, de los cuales el 15% son mujeres en edad fértil. Estas infecciones suelen ser asintomáticas o causar síntomas leves en el adulto (como fiebre, malestar general y linfadenopatía), pero la infección en la mujer embarazada puede provocar graves problemas de salud en el feto si se transmite el parásito (toxoplasmosis congénita) y ocasionar secuelas graves en el bebé como coriorretinits, retraso mental, ceguera, sordera sensorineural y epilepsia. No hay evidencia concluyente de que la prueba y el cuidado preconcepcional reduzcan la infección por Toxoplasma gondii o mejoren el tratamiento de las mujeres infectadas. Por otro lado, si se realiza el asesoramiento preconcepcional, las mujeres que dieron positivo pueden estar tranquilas de que no corren riesgo de infección durante el embarazo y las que dieron negativo pueden recibir consejos sobre cómo prevenir la infección. Las mujeres que se infectan durante el embarazo deben recibir tratamiento. Se deben implementar programas educativos y de detección temprana para las embarazadas que sean rentables para reducir el impacto financiero y emocional de esta enfermedad.


Toxoplasmosis is an infection caused by the single-celled parasite Toxoplasma gondii. According to serologic surveys from the Third National Health and Nutrition Survey in the United States, about 23% of adolescents and adults have serologic signs of T. gondii infection, of which 15% are women of childbearing age. These infections are usually asymptomatic or cause mild symptoms in the adult (such as fever, malaise, and lymphadenopathy), but infection in the pregnant woman can cause serious health problems in the fetus if the parasite is transmitted (congenital toxoplasmosis) and cause severe sequelae in the infant such as chorioretinits, mental retardation, blindness, sensorineural deafness, and epilepsy. There is no conclusive evidence that preconception testing and care reduces Toxoplasma gondii infection or improves treatment of infected women. On the other hand, if preconception counseling is performed, women who tested positive can be reassured that they are not at risk of infection during pregnancy and those who tested negative can receive advice on how to prevent infection. Women who become infected during pregnancy should be treated. Cost-effective educational and early detection programs for pregnant women should be implemented to reduce the financial and emotional impact of this disease.


[1] Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–1994. Vital Health Stat [1] 1994;32: 1–407.

[2] Jones J.L, Lopez A., Wilson M., Sxhulkin J., Gibas R. Congenital Toxoplasmosis: A Review. Obstet and Gynecol Survey 2001; volume 56, number 5: 296-305.

[3] Rorman E., Stein Zamir C., Rilkis I., Ben-David H. Congenital Toxoplasmosis – prenatal aspects of Toxoplasma gondii infection. Reprod Toxicology 2006; 21: 458-472.

[4] Black MW, Boothroyd JC. Lytic cycle of Toxoplasma gondii. Microbiol Mol Biol Rev 2000;64:607–623

[5] Vogel N, Kirisits M, Michael E et al. Congenital toxoplasmosis transmitted from an immunologically competent mother infected before conception. Clin Infect Dis 1996;23:1055–1060

[6] Dunn D, Wallon M, Peyron F et al. Mother-to-child transmission of toxoplasmosis: Risk estimates for clinical counselling. Lancet 1999;353:1829–1833.

[7] Holliman RE. Congenital toxoplasmosis: prevention, screening and treatment. J Hosp Infect 1995;30(Suppl):179–190.

[8] Barragan A, Sibley LD. Migration of Toxoplasma gondii across biological barriers. Trends Microbiol 2003;11:426–30.

[9] Hoff EF, Carruthers VB. Is Toxoplasma egress the first step in invasion? Trends Parasitol 2002;18:251–5

[10] Kasper LH, Mineo JR. Attachment and invension of host cell by Toxoplasma gondii. Parasitol Today 1994;10:82–5.

[11] Sibley L.D. Intracellular Parasite Invasion Strategies. Science. 2004 Apr 9; 304(5668):248-53.

[12] A. P. Sinai, K. A. Joiner, The Toxoplasma gondii protein ROP2 mediates host organelle association with the parasitophorous vacuole membrana. J. Cell Biol 2001; 154, 95

[13] Opitz C, Soldati D. ’The glideosome’: a dynamic complex powering gliding motion and host cell invasion by Toxoplasma gondii. Mol Microbiol 2002;45:597–604.

[14] Su C, Howe DK, Dubey JP, Ajioka JW, Sibley LD. Identification of quantitative trait loci controlling acute virulence in Toxoplasma gondii. Proc Natl Acad Sci USA 2002;99:10753–8.

[15] Correa D., Cañedo-Solares I., Ortiz-Alegría B., Caballero-Ortega. And Rico-Torres P. Congenital and acquired toxoplasmosis: diversity and role of antibodies in different compartments of the host. Parasite Immunology 2007, 29; 651-660.

[16] Robbins J R, Bakardjiev A. I. Pathogens and the placental fortress. Current Opinion in Miocrobiology 2012; 15:36-43

[17] Mor G, Cardenas I. The immune system in pregnancy: a unique complexity. Am J Reprod Immunol. 2010 Jun;63(6):425-433.

[18] Pfaff A. W., Abou-Bacar A., Letscher-Bru V., Villard O., Senegas A., Mousli M., and Candolfi E. Cellular and molecular physiopathology of congenital toxoplasmosis: The dual role of IFN-gamma. Parasitology 2007; 134(Pt 13), 1895 – 902.

[19] Szekeres-Bartho, J. Immunological relationship between the mother and the fetus. International Reviews in Immunology 2002; 21, 471 – 495.

[20] Ajzenberg, D., Cogne, N., Paris, L., Bessieres, M. H., Thulliez, P., Filisetti, D., Pelloux, H., Marty, P. and Darde, M. L. Genotype of 86 Toxoplasma gondii isolates associated with human congenital toxoplasmosis, and correlation with clinical findings. Journal of Infectious Diseases 2002; 186, 684–689.

[21] Berghella V, Buchanan E, Pereira L, Baxter J. Preconception Care. Obstet Gynecol Surv. 2010. Feb; 65(2):119-31

[22] Jonson K, Posner SF, Biermann J, et al. Recommendations to improve preconception health and health care – United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel of Preconception Care. MMWR Recomm Rep 2006;55(RR-6):1-23.

[23] Disponible en:

[24] Atrash H, Jack BW, Jonson K. Precoception care: a 2008 update. Curr Opin Obstet Gynecol. 2008, 20:581-89

[25] Curtis MG. Preconception care: a clinical case of “think globally, act locally”. Am J Obstet & Gynecol. 2008 Dec;199:6(Suppl 2)S:257-8.

[26] Moos MK, Dunlop AL, Jack BW, Nelson L, et al. Healthier women, healthier reproductive outcomes: recommendatios for the routine care of all women. Am J Obstet & Gynecol. 2008 Dec;199:6(Suppl 2)S:280-9.

[27] Coonrod DV, Jack BW, Stubblefield PG, Hollier lM, et al. The clinical content of preconception care: infectious diseases in preconception care. Am J Obstet & Gynecol. 2008 Dec;199:6(Suppl 2)S:296-309.

[28] Paquet C, Yudin MH. Toxoplasmosis in pregnancy; prevention, screening, and treatment. J Obstet Gynaecol Can. 2013 Jan;35(1):78-9.

[29] Deganich M, Boudreaux C, Benmerzouga I. Toxoplasmosis Infection during Pregnancy. Trop Med Infect Dis. 2022 Dec 21;8(1):3.