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    Toxoplasmosis Serologic Testing Algorithm

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    Hanny Prasetiana Yurianti
    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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    Toxoplasmosis Serologic Testing Algorithm

    Uploaded by

    Hanny Prasetiana Yurianti
    22 views1 page
    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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    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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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    22 views1 page

    Toxoplasmosis Serologic Testing Algorithm

    Uploaded by

    Hanny Prasetiana Yurianti
    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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    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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