Congenital Toxoplasmosis with Bilateral Macular Chorioretinitis in a Premature NewbornKongenitale Toxoplasmose mit bilateraler Makulachorioretinitis bei einem Frühgeborenen
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) , . Despite these new recommendations, a significant number of pregnant women continue to be tested for toxoplasmosis in Switzerland .
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 .
Eingereicht: 25. September 2020
Angenommen: 25. Januar 2021
30. April 2021 (online)
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