Klin Monbl Augenheilkd 2021; 238(04): 431-433
DOI: 10.1055/a-1384-1359
Der interessante Fall

Congenital Toxoplasmosis with Bilateral Macular Chorioretinitis in a Premature Newborn

Kongenitale Toxoplasmose mit bilateraler Makulachorioretinitis bei einem Frühgeborenen
1  Unit of Strabology and Pediatric Ophthalmology, University Department of Ophthalmology, Jules Gonin Eye Hospital, Lausanne, Switzerland
,
Jacques Bijon
2  Unit of Strabology, University Department of Ophthalmology, Jules Gonin Eye Hospital, Lausanne, Switzerland
,
Pierre Alex Crisinel
3  Unit of Pediatric Infectious Diseases and Vaccinology, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
,
Anita C. Truttmann
4  Clinic of Neonatology, Department of Women, Mother and Child, University Hospital of Lausanne, Lausanne, Switzerland
,
Jacques Durig
5  Ophthalmology, Métropole médical, Lausanne, Switzerland
6  Department of Women, Mother and Child, University Hospital of Lausanne, Lausanne, Switzerland
,
Daniele C. Rossi
7  Unit of Ocular Immuno-Infectiology, University Department of Ophthalmology, Jules Gonin Eye Hospital, Lausanne, Switzerland
› Author Affiliations

Background

Toxoplasmosis is a widespread parasitic disease that can be transmitted transplacentally. Maternal toxoplasmosis infection acquired during pregnancy is rare but carries a significant risk of fetal damage, i.e., severe visual impairment and neurologic sequelae. In Lausanne, a retrospective review made between 1995 and 2006 reported a total number of 37 serologically confirmed cases of congenital toxoplasmosis (CT), accounting for 1 case in 2270 live births, including 1 symptomatic case in infancy per 14 000 live births. It can thereof be anticipated that among 73 000 pregnancies 130 women will have toxoplasmosis during pregnancy each year in Switzerland, of which 4.5 symptomatic cases of CT will be expected. Therefore, the Swiss working group on CT recommended in 2008 to cease systematically testing for toxoplasma antibodies before and during the pregnancy and to insist on recommendations to prevent toxoplasmosis seroconversion during pregnancy, as a fairly high number of pregnant women had to be screened to find one symptomatic case (i.e., one symptomatic case every 16 222 patients tested) [1], [2]. Despite these new recommendations, a significant number of pregnant women continue to be tested for toxoplasmosis in Switzerland [3].

Fetal damage caused by CT is detectable by ultrasound screening when severe central nervous system lesions are present. However, toxoplasmic chorioretinitis (TCR), which occurs mainly after late maternal infection, is commonly isolated and thus not accessible to prenatal diagnosis. Indeed, the diagnosis of TCR is established by ocular funduscopy carried out at birth and regularly thereafter, as TCR can occur at any time in fetal or postnatal life [4].



Publication History

Received: 25 September 2020

Accepted: 25 January 2021

Publication Date:
30 April 2021 (online)

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