Neonatal Toxoplasmosis Research Articles

Sero-epidemiological Study of Toxoplasmosis in Neonates and Postpartum Mothers Referred to Health Centers of Yazd in Iran during 2020

Sero-epidemiological Study of Toxoplasmosis in Neonates and Postpartum Mothers Referred to Health Centers of Yazd in Iran during 2020

Temporal-spatial distribution of reported congenital toxoplasmosis in para state

Congenital toxoplasmosis is an important public health problem in Brazil, and it started to have compulsory notification in 2016. In the northern region of the country, in the state of Pará, in the Amazon, prevalence rates are high, and this research aimed to assess longitudinally, between 2012-2021 the reported cases according to geographic location by municipality, year, race, gestational period and maternal education, based on official data from the State Department of Health. 117 cases were reported in 40 of the 144 municipalities in Pará, predominating in 8 of these: Redenção (16.2%), Belém (15.4%), Paragominas (10.3%), Tucuruí (6.8%) and others. with an average of 1,667 cases. Most occurred after 2016 (78 cases), especially in 2019 (20.51%), in the second (50%) and third trimester (33.3%) of pregnancy, respectively, in pardos (76.92%), with mothers with low education (14 out of 30 notified). There are achievements in the surveillance and control of toxoplasmosis, however it is necessary that the management of the municipalitiescompromise to structure the health network for the diagnosis of gestational and neonatal toxoplasmosis, since it was observed that less than a third of the municipalities are making the notifications.

Seroprevalence of Gestational and Neonatal Toxoplasmosis as well as Risk Factors in Yaoundé, Cameroon.

Background Toxoplasmosis, caused by Toxoplasma gondii in pregnant women, is a significant public health problem due to risk of mother to child transmission. The aim of the study was to determine the seroprevalence of toxoplasmosis in pregnant women and corresponding cord blood among women attending Biyem-Assi and CASS Nkoldongo hospitals in Yaoundé, Cameroon. Methods An institutional based cross-sectional study was conducted between June 2019 and May 2020 on 300 pregnant women from late second trimester to third trimester. A total of 259 cord blood samples were collected at birth from these women. Toxoplasma gondii-specific IgG and IgM antibodies in maternal and cord blood were detected using the Toxoplasma Enzyme Immunosorbent Assay kit, and potential risk factors captured through questionnaire were identified using binary logistic regression model. Statistical significance was measured at P < 0.05. Results The overall seroprevalence of gestational and neonatal toxoplasmosis was 80% and 88%, respectively. IgG seropositivity was 72.7%, IgM only was 1.3% and cooccurrence of IgG/IgM was 6% amongst pregnant women. Out of 259 newborn cord bloods, 72.2% were positive for IgG only, 8.9% for IgM only, and 23.9% for both IgG/IgM. Pregnant women 15-24 years (AOR = 4.6, P = 0.011) and women with primary level of education (AOR = 3.9, P = 0.042) were significantly at risk of infection with Toxoplasma gondii. Conclusion Gestational and neonatal toxoplasmosis appears to be more common with higher risk of infection in younger women and less educated women. Hence, these findings will serve as baseline data for further investigations on mother to child transmission of toxoplasmosis in Yaoundé and the need for reinforcement of pregnant women toxoplasmosis-related health measures.

Frequency of Toxoplasma Infection Among Pregnant Women and Their Newborn in Kashan, Iran

test. Results: Five (0.63%) and 341 (42.7%) were positive for acute and chronic infections. A 400 bp band was seen in 3 newborns of acute maternal infections. The incidence of neonatal toxoplasmosis was 3.7 per 1000. Only one neonate of the acute maternal toxoplasmosis had jaundice. Conclusions: The rate of maternal and neonatal toxoplasmosis, were higher than the world. Jaundice was only sign in newborn with Toxoplasma gondii infection.

Gestational and congenital toxoplasmosis in two hospitals in Bogota, Colombia

Background. Gestational toxoplasmosis is acquired during pregnancy and involves a risk of the parasite crossing the placenta, thereby leading to foetal infection, which can lead to serious sequelae in children, mainly chorioretinitis, cerebral calcification, hydrocephalus and intellectual disability. Objective. Determining the prevalence of maternal and neonatal toxoplasmosis in women attending the Engativa and La Victoria hospitals in Bogota, Colombia, for delivery. Correlating the results with those of a national multicentre study. Determining IgM and IgA anti-toxoplasma prevalence in newborn (NB) umbilical cord blood. Materials and methods. This was a cohort study, which was approved by the participating institutions’ ethics committees. The patients signed informed consent forms and filled out a survey requesting demographic and prenatal care data. A blood sample was taken from the umbilical cord on delivery for determining anti-toxoplasma IgM. Anti-toxoplasma IgA was also measured in a subset of patients. Children suspected of having either clinical or serological congenital toxoplasmosis were followed-up for 12 months. Results. The study involved taking 3,224 NB umbilical cord blood samples between April 1st 2009 and July 16th 2010. Positive anti-toxoplasma IgG was found in 28.2% of pregnant women (26.1-29.8 95%CI). Anti-toxoplasma IgM was determined in 558 pregnant women and found positive in 34 patients (i.e. 1.1 per 100 NB gestational toxoplasmosis incidence). Nine blood samples were positive (7 for IgM and 2 for IgA). Five of the NB studied (0.15%) were positive for IgG after 12 months’ follow-up, thereby confirming a diagnosis of congenital toxoplasmosis accounting for 1 in every 645 live births. Conclusion. This study showed that 70% of the pregnant women were not infected with T. gondii in the chosen hospitals in Bogota. Gestational toxoplasmosis frequency was around 1% and 0.6% for congenital toxoplasmosis.

Ocular toxoplasmosis in an immunocompetent 8-year-old child: a new active lesion or a late manifestation of a congenital toxoplasmosis?

Infection with the protozoan Toxoplasma gondii is one of the most frequent parasitic infections worldwide and the common infection of the retina in the general population. We describe a case report of a chorioretinitis in an immunocompetent 8-year-old patient as a consequence of a underdiagnosed neonatal toxoplasmosis. The boy was successfully managed with pyrimethamine and sulfadiazine. The present case we would like to empathize the importance of considering toxoplasma gondii as a possible cause of chorioretinitis in children living in developed countries and we provide a detailed reviewed of the literature about treatment of Toxoplasma gondii infection.

W047 INCIDENCE OF TOXOPLASMOSIS IN NEONATES AND ITS COMPLICATIONS

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S720-S720 Poster presentations W047 INCIDENCE OF TOXOPLASMOSIS IN NEONATES AND ITS COMPLICATIONS S. Rasti, S. RastiSearch for more papers by this authorA. Fatahian, A. FatahianSearch for more papers by this authorM. Bandepour, M. BandepourSearch for more papers by this authorA. Talebian, A. TalebianSearch for more papers by this authorG. Moosavi, G. MoosaviSearch for more papers by this author S. Rasti, S. RastiSearch for more papers by this authorA. Fatahian, A. FatahianSearch for more papers by this authorM. Bandepour, M. BandepourSearch for more papers by this authorA. Talebian, A. TalebianSearch for more papers by this authorG. Moosavi, G. MoosaviSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61773-1Citations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S720-S720 RelatedInformation

Congenital Toxoplasmosis: Evaluation of Molecular and Serological Methods for Achieving Economic and Early Diagnosis Among Egyptian Preterm Infants

Early diagnosis of congenital toxoplasmosis (CT) is difficult when specific immunoglobulin M (IgM) antibodies are absent, or if persist for months, in the newborn infant's blood. To study the risk factors of neonatal toxoplasmosis and to compare different immunologic profiles (Toxoplasma-specific IgM, IgA antibodies and the avidity of IgG antibodies) with polymerase chain reaction (PCR) for reaching economic and early postnatal diagnosis. We prospectively studied 80 preterm neonates, recruited from neonatal intensive care units (NICUs) of Cairo University hospitals. Whose gestational age ≤ 34 weeks with (n = 60) or without (n = 20) CT risk. Serum samples for specific IgA, IgM antibodies and avidity of IgG toxoplasma antibodies were measured by ELISA then compared to PCR. Of the 60 studied cases, 16 (26.7%) were positive for toxoplasmosis by PCR, of which 15 (25%) had low avidity of IgG antibodies (positive), 14 (23.3%) were positive for IgA and 10 (16.7%) were positive for IgM, with sensitivity for avidity of IgG, IgA and IgM: 93.2%, 87.5% and 62.5%, respectively. Determination of avidity of IgG toxoplasma antibodies and/or serological detection of specific IgA for toxoplasmosis offer, simple tests for diagnosis of congenital toxoplasmosis with (better sensitivity) than IgM.

Human medical view on zoonotic parasites

Human medical view on zoonotic parasites

Delayed onset of severe neonatal toxoplasmosis

We report a case of severe neonatal infection on day 6 of life due to Toxoplasma gondii mimicking septic shock syndrome associated with multiple organ failure such as acute respiratory distress syndrome with persistent pulmonary hypertension, neurological distress, thrombocytopenia with disseminated intravascular coagulopathy and transaminitis. Clinicians facing an unexplained life-threatening condition in the first week of life should take into consideration the possibility of neonatal toxoplasmosis.

A systematic review of neonatal toxoplasmosis exposure and sensorineural hearing loss

Introduction The Joint Committee on Infant Hearing 2007 Position Statement includes in utero toxoplasmosis infection as a risk indicator for delayed-onset or progressive sensorineural hearing loss. It is recommended that children with congenital toxoplasmosis infection undergo audiologic monitoring to identify congenital and delayed-onset sensorineural hearing loss. Objective To determine the prevalence of sensorineural hearing loss and to develop evidence-based guidelines for audiologic monitoring of children born with congenital toxoplasmosis infection. Data sources Systematic search of Medline, EMBASE and Cochrane databases and manual search of references. Study selection Longitudinal studies reporting an inception cohort identified at birth, with serologic confirmation of toxoplasmosis infection, and long-term serial audiometric evaluation. Data extraction Independent extraction of patient and audiometric data. Data synthesis Descriptive statistics. Conclusion The five studies meeting our inclusion criteria report a prevalence of toxoplasmosis-associated hearing loss from 0% to 26%. Improved treatment regimens for toxoplasmosis may account for this range. Three treatment groups were identified and a subgroup analysis of the compiled data was performed. In children receiving limited or no treatment, the prevalence of toxoplasmosis-associated SNHL was found to be 28%. In children prescribed 12 months of antiparasitic treatment but in whom treatment was not confirmed to have started prior to 2.5 months of age and in whom compliance was not ensured, the prevalence of SNHL was 12%. In children treated with 12 months of antiparasitical therapy initiated prior to 2.5 months of age with serologically-confirmed compliance, the prevalence of SNHL was 0%. Only two longitudinal studies were identified and neither reported any cases of delayed-onset or progressive toxoplasmosis-associated SNHL. Children who have received a 12-month course of antiparasitical therapy initiated prior to 2.5 months with serologically-confirmed compliance should have repeat audiometric evaluation at 24–30 months of age. Children with congenital toxoplasmosis that had no treatment, partial treatment, delayed onset of treatment, or compliance issues should undergo annual audiologic monitoring until able to reliably self-report hearing loss.

Prevalence of Toxoplasma gondii antibodies in stray cats in Sari, northern Iran

Cats are important in the epidemiology of Toxoplasma gondii because they are the only hosts that can excrete environmentally resistant oocysts. T.gondii is a major zoonotic agent which infects up to one-third of the world population. Toxoplasmosis in neonates and immunocompromised patients can lead to severe disease and death. A cross- sectional parasitological and serological survey with latex agglutination test (LAT) to detect anti-T. gondii antibodies was conducted on 100 serum samples collected from stray cats in five urban areas of Sari, Northern Iran, from April to November 2004. Classification by age, sex, weight, season and region was made. Results analyzed according to specific variables. The overall prevalence of T. gondii IgG antibodies (LAT titre > or = 1:1) were found in 40 of 100(40%) of stray cats, with regional variations. Overall 16 of 100(16%) of stray cats had diagnostically significant antibody titres (LAT > or = 1:64). Prevalence was significantly higher in adult cats (1.5-3.0 kg, 54.5% of 66) than in juvenile cats and kittens (< or = 1.4 kg, 11.8% of 34) and higher in female stray cats (44.4% of 72) than in male stray cats (28.6% of 28). Toxoplasma seroprevalence was highest in the season of spring (22.4%). There was a significant difference in the prevalence of infection relative to host age and weight (P < 0.05). No significant difference was found between the prevalence of infection relative to host gender, urban sites and season (P > 0.05). Prevalence of T. gondii oocyst was also analyzed by a routine coprological method in 100 cats. T. gondii oocysts were not found in any faecal samples analyzed. Only 2 out of 100 smear preparations of intestinal mucosa showed trophozoites of T. gondii.

Seroprevalence of Toxoplasma gondii in Sweden, Estonia and Iceland

Toxoplasmosis is a disease caused by the intracellular protozoan parasite, Toxoplasma gondii which infects up to one-third of the world human population. Toxoplasmosis in neonates and immunocompromised patients can lead to severe disease and death. We investigated the prevalence and risk factors for T. gondii infection in Iceland, Sweden and Estonia, and tested the hypothesis that T. gondii infection causes systemic inflammation and protects against atopy. Blood samples were collected from 1277 randomly selected subjects. The presence of T. gondii IgG antibodies was determined by an ELISA method and levels of Hs-CRP by immunoturbidimetric assay. The prevalence of T. gondii antibodies was 54.9% in Tartu, 23% in Uppsala and 9.8% in Reykjavik (p<0.0001). The risk of positive T. gondii antibodies increased with the number of siblings and with age in Sweden. T. gondii infection was associated with asthma related symptoms and increased Hs-CRP (p = 0.02). No association was found with IgE-sensitization and lung function. We concluded that risk factors for T. gondii infection suggested that soil exposure was 1 of the mechanisms in all 3 countries and a meat-associated infection route is a risk in Sweden.

Severe Neonatal Toxoplasmosis After Third Trimester Maternal Infection

We report an unusual case of neonatal toxoplasmosis. After a late third trimester maternal infection, the infant developed severe disseminated intravascular coagulopathy with thrombocytopenia, hepatitis, jaundice and severe pneumonitis. Clinicians that manage infants with severe unexplained systemic disease should consider the possibility of congenital toxoplasmosis.

La prévention de la toxoplasmose congénitale en France. Évaluation des risques. Résultats et perspectives du dépistage anténatal et du suivi du nouveau-né

In France, a national program for the prevention of congenital toxoplasmosis has been set up 25 years ago. This program is here presented and discussed in details. It is based on a decision tree well defined, with pre and/or per gravidic serological screening with several different tests, completed, if necessary, by ultrasounds examinations of the fetus, biomolecular tests (PCR) on amniotic fluid, and by clinical, biological, and radiological surveillance of neo-nates. The purpose of this prevention program is to: 1/identify nonimmune young women and limit their contamination risk during pregnancy by appropriate counseling on hygiene and diet; 2/screen and treat per gravidic toxoplasmosis as early as possible so as to prevent or limit transmission to the fetus and its consequences. 3/in utero diagnose and treat infestation of the fetus; 4/diagnose and treat asymptomatic congenital toxoplasmosis in neonates, to prevent risks of reactivation and late complications, especially ocular. Such a prevention program has a cost validated by the prevalence of acquired toxoplasmosis in adults in France (over 50% of the population) and by the yearly incidence of congenital toxoplasmosis (at least 0.1% of births according to the best hypothesis). These 6 to 700 congenital toxoplasmosis cases per year may be compared to the 6 to 7,000 per gravidic seroconversions which could lead to fetal contamination if no preventive measures are taken. Nevertheless, as it is often the case in the field of prevention, it is very difficult to statistically assess the efficacy of this program even though several arguments show that it allows to eliminate the most serious toxoplasmosis, sources of serious handicaps at birth, and to limit the frequency of late complications (especially retino-choroiditis) of asymptomatic infections in neonates. The position of European countries varies as to prevention of congenital toxoplasmosis. Some countries (Austria, Belgium) have national prevention programs similar to the French one, whereas others have set up only limited programs or set up no systematic prevention. These differences may be accounted for by the different frequencies of toxoplasmic risk. It seems mandatory to forget all dogmatism and not to stick to a strictly statistical approach for a disease with not only medical but also social and human consequences.

Maternal and neonatal prevalence of toxoplasma and cytomegalovirus (CMV) antibodies and hepatitis-B antigens in an Egyptian rural area.

To determine the seroprevalence of maternal and neonatal toxoplasmosis and cytomegalovirus (CMV) antibodies and hepatitis-B (HB) antigenaemia in a rural Egyptian area, a prospective serological study was done on a randomly selected sample of pregnant women (n = 150) and their newborn infants (n = 150). Sera were collected from the mothers during the first antenatal visit, and at the time of delivery and cord blood specimens (paired samples) taken from their infants to be tested for toxoplasma-IgG and IgM antibodies, CMV-IgG and IgM antibodies surface antigen (HBsAg) and HBe antigen (HBeAg). Maternal infection was indicated in cases where specific IgM antibody was present or where an initial maternal specimen gave negative result for IgG antibody, but the second blood specimen gave positive result. Specific IgM antibody in a cord blood specimen indicated fetal infection. Out of the 150 pregnant women, 64 (43 percent) were toxoplasma immune at their first antenatal visit and their newborns were toxoplasma IgG positive. Toxoplasma specific IgM antibody was detected in only three mothers at the time of deliver. The rate of maternal infection in susceptible pregnancies was 4 percent and the maternal-fetal transmission rate was estimated to be 33 percent, as only one newborn infant had toxoplasma-IgM antibody at birth. This denoted a prevalence of congenital toxoplasma infection = < 1.0 percent to non-immune mothers. There were no clinical features of congenital infection in the infant with toxoplasma-IgM antibody, but he will require long-term follow-up. All the mothers infected during pregnancy had known risk factors for toxoplasma infection. One-hundred-and-forty-three (96 percent) of the pregnant women were CMV-IgG seropositive at their first antenatal visit. At the time of delivery 143 (96 percent) of the mothers and their newborn infants were CMV-IgG seropositive. None of the mothers or their infants was CMV-IgM seropositive. HBsAg was detected in 8 per cent of pregnant mothers (n = 12) and in two (17 percent) of their newborn infants. None of the mothers was HBeAg positive. In conclusion, the prevalence of toxoplasma infection during pregnancy and its transplacental transmission rate in a rural Egyptian area are high compared to other countries. A toxoplasmosis antenatal screening and public education programmes for pregnant mothers is justifiable in rural Egypt. However, it appears that an antenatal screening programme for CMV is, at present, not warranted.

Lesions of neonatally induced toxoplasmosis in cats.

Five pregnant queens were inoculated orally with Toxoplasma gondii tissue cysts. Twenty-two live and three dead kittens were born 16 to 31 days after inoculation. Four kittens were eaten by queens and, thus, were not available for histologic examination. Twenty-one kittens that died or were euthanatized on day 2 (two kittens), 4 (one kitten), 5 (five kittens), 6 (five kittens), 7 (one kitten), 8 (four kittens), 16 (two kittens), and 29 (one kitten) after birth were studied histologically. T gondii was detected by bioassay and was seen in histologic sections of tissues from all 21 kittens. The histologic lesions associated with neonatal toxoplasmosis were widely disseminated infiltrates of macrophages and neutrophils often accompanied by necrosis; lymphocytes and plasma cells were occasionally present. The most consistent lesions were proliferative interstitial pneumonia (21/21); necrotizing hepatitis (20/21); myocarditis (21/21); skeletal myositis (21/21); glossal myositis (19/19); nonsuppurative encephalitis affecting the cerebrum (18/18), brain stem (15/15), and spinal cord (9/9); uveitis (19/19); necrotizing adrenal adenitis (18/18); and interstitial nephritis (16/21). Placental lesions (2/2) consisted of grossly visible areas of necrosis and mineralization.

Diagnosis of induced toxoplasmosis in neonatal cats

Summary Sixteen pregnant queens were inoculated orally with tissue cysts of Toxoplasma gondii, and fetal membranes and offspring were examined for Τ gondii infection by bioassay in mice. Queens appeared clinically normal, although all shed Τ gondii oocysts. Toxoplasma gondii was isolated from tissues of 7 of 33 fetuses or kittens from 5 litters (at 13, 23, 26, 27, and 29 postinaculation days) from 8 queens euthanatized between 10 and 31 postinoculation days. Infection with Τ gondii was found In kittens from all 8 litters from the 8 queens that were allowed to undergo parturition and nurse their kittens. A total of 43 kittens were born to these 8 quean. Toxoplasma gondii was isolated from tissues of 26 of 40 kittens bioassayed; in 3 kittens, tissues were not available for bioassay. Toxoplasmosis was severe in full-term kittens born to 5 queens; all 25 kittens from these litters died or were ill by 24 days of age. Anorexia, lethargy, hypothermia, and sudden death were the most common manifestations. Cytologic examination of peritoneal fluid aspirate samples and determination of hepatic-associated enzyme concentrations in affected kittens, as well as measurement of anti-T gondii antibodies in serum of kittens and queens, were helpful in the diagnosis of neonatal toxoplasmosis. Transplacental transfer of anti-T gondii antibodies was not observed in cats. Toxoplasma gondii oocysts were found in fecal samples of 3 kittens from different litters at 16, 24, and 63 days of age.

Histologically confirmed clinical toxoplasmosis in cats: 100 cases (1952–1990)

Summary Tissue sections from 119 cats that died or were euthanatized (1952-1990) because of toxoplasmosis-like illness were reexamined for Toxoplasma gondii by direct microscopy and immunohistochemical staining with anti-T gondii serum. Clinical and pathologic data from 100 of these cats with histologically verified toxoplasmosis were then analyzed. Of these 100 cats, 36 were considered to have generalized toxoplasmosis, 26 predominantly pulmonary lesions, 16 abdominal, 2 hepatic, 1 pancreatic, 1 cardiac, 2 cutaneous, 7 neurologic, and 9 had neonatal toxoplasmosis. In 14 cats, concurrent microbial infections or other maladies were seen. Cats were 2 weeks to 16 years old (median, 2 years; mean, 4 years). Sixty-five cats were males and 34 were females; sex was not recorded for 1 cat. Of 67 cats that had rectal temperatures recorded, 49 (73%) had fever (40.0 to 41.7 C). Dyspnea, polypnea, and signs of abdominal discomfort were frequently observed. Toxoplasmosis had been confirmed antemortem in 8 cats; 4 had a serum antibody titer to T gondii of ≥ 1:1,024; and T gondii had been found in cytologic evaluation of tracheal aspirates from 2 cats and pleural fluid from 1 cat, as well as in a biopsy specimen of a mesenteric lymph node from another. Of the 15 cats with T gondii serum-antibody titers determined by the Sabin-Feldman dye test, 6 had no antibody detected in 1:4 dilution of their serum. Indirect fluorescent antibody titers were found in 10 of 10 cats' sera tested. Forty-one eyes from 27 of the cats were examined microscopically. Twenty-two of the 27 cats (81.5%) had evidence of intraocular inflammation in one or both eyes. Multifocal iridocyclochoroiditis was the most common lesion and was seen in 18 (81.8%) of the cats with ophthalmitis. The ciliary body was the most often severely affected portion of the uvea. Of the 22 cats with ocular toxoplasmosis, T gondii was found in eyes of 10. Toxoplasma gondii was found in the retina of 5 cats, the choroid of 2, the optic nerve of 1, the iris of 3, and the ciliary body of 4. Toxoplasma gondii was identified in 80% of 55 brains, 70.0% of 90 livers, 76.7% of 86 lungs, 64.4% of 45 pancreata, 62.7% of 59 hearts, 45.8% of 72 spleens, 41.5% of 65 intestines, 17.7% of 61 kidneys, and 60.0% of 30 adrenal glands.

PLACENTAL TOXOPLASMOSIS

The various lesions of placental toxoplasmosis are described. Evidence to support the view that neonatal toxoplasmosis originates from an infection of the developing placenta is provided. Observations of other workers have shown that quiescent endometrial and uterine phases of the infection provide the nidus from which obstetrical infections originate. Toxoplasma organisms are further shown in various free and encysted forms within the advancing syncytiotrophoblast and villus stroma of the placenta. The significant variations in the inflammatory lesions are believed to depend largely upon the degree of parasitemia.