Congenital Toxoplasmosis in Tunisia: Prenatal and Neonatal Diagnosis and Postnatal Follow-up of 35 Cases
| Autor: | O. Souissi, Yosr Boudaouara, Rania Maatoug, Aïda Bouratbine, Rym Ben Abdallah, Karim Aoun |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty Tunisia Amniotic fluid 030231 tropical medicine 030106 microbiology Antiprotozoal Agents Sulfadiazine Prenatal diagnosis Toxoplasmosis Congenital Serology 03 medical and health sciences 0302 clinical medicine Pregnancy Prenatal Diagnosis Virology Humans Medicine Pregnancy Complications Infectious Retrospective Studies Fetus biology business.industry Infant Newborn Chorioretinitis Toxoplasma gondii Articles DNA Protozoan biology.organism_classification medicine.disease Toxoplasmosis Pyrimethamine Infectious Diseases Immunoglobulin M Immunoglobulin G Drug Therapy Combination Female Parasitology business Toxoplasma |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene. 98:1722-1726 |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | Congenital toxoplasmosis (CT) results from transplacental passage of Toxoplasma gondii to the fetus during acute maternal infection. Our study aims to report clinical and biological patterns of 35 cases of CT diagnosed at the department of the Parasitology of the Pasteur Institute of Tunis and to access the performance of prenatal and early postnatal diagnosis techniques. Serological screening of maternal infection was performed by Immunoglobulin (Ig) M and IgG detection and IgG avidity determination. Prenatal diagnosis was based on both Toxoplasma DNA detection in the amniotic fluid and monthly ultrasound examinations. polymerase chain reaction analysis on amniotic fluid, performed only in 15 cases, detected Toxoplasma’s DNA in five cases (33.3%). Ultrasound examination did not reveal any morphological abnormalities. Thirty newborns had serological criteria of Toxoplasma infection. Congenital toxoplasmosis diagnosis was confirmed in 23 cases (76.6%) by immunoblot. Among the 35 born-infants, five (14.3%) were symptomatic: three had chorioretinitis at the first clinical ocular examination, one had neurological symptoms (seizures) with positive parasite DNA in cerebral spinal fluid, and one had both ophthalmological and neurological damages— chorioretinitis and intracranial calcifications in the computed tomography scan. Thirty-four of 35 infected children were treated with pyrimethamine–sulfadiazine combination. Four (11.7%) of the treated infants showed abnormal hematological values because of the treatment side effect. Serological rebound was observed in seven infants. A screening program and a diagnostic algorithm in pregnant women should be implemented in Tunisia to improve the follow-up of seronegative ones and to prevent CT cases. |
| Databáze: | OpenAIRE |
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