How Do I Treat a Pregnant Woman With a Macula-Threatening Toxoplasmosis Lesion?

Toxoplasma gondii is the leading cause of infectious posterior uveitis worldwide. Macula- or vision-threatening retinochoroiditis or optic nerve involvement represents indication for treatment. However, unique to pregnancy is the urgency of preserving a mother's vision in addition to limiting, if not preventing, vertical transmission of the parasite, which may lead to severe comorbid effects or even termination of the pregnancy. Reactivation of congenital lesions is the classic teaching as to the etiology behind retinochoroiditis, but as more cases of acquired toxoplasmosis are recognized, this notion may change. Acquired toxoplasmosis commonly occurs from the consumption and handling of raw or undercooked meat (especially pork) or from the cleaning of cat litter boxes by pregnant women.