Congenital toxoplasmosis from a chronically infected woman with reactivation of retinochoroiditis during pregnancy - an underestimated event?

J Pediatr (Rio J). 2009 Nov 16;86(1). [Epub ahead of print]

Congenital toxoplasmosis from a chronically infected woman with reactivation of retinochoroiditis during pregnancy - an underestimated event?

Andrade GM, Vasconcelos-Santos DV, Carellos EV, Romanelli RM, Vitor RW, Carneiro AC, Januario JN.

Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

OBJECTIVE: To report a rare case of congenital toxoplasmosis from an immunocompetent mother with chronic infection who had reactivation of ocular disease during pregnancy. DESCRIPTION: The newborn was asymptomatic at birth and identified by neonatal screening (IgM anti-Toxoplasma gondii in dried blood) among other 190 infants with congenital toxoplasmosis during a 7-month period. His mother had had a non-treated episode of reactivation of toxoplasmic retinochoroiditis during pregnancy, with stable IgG titers and negative IgM results. Results of IgM and IgG in the newborn's serum, as well as IgG immunoblotting were positive and active retinochoroidal lesions were detected in his peripheral retina. The neonate was treated with sulfadiazine, pyrimethamine and folinic acid. At 14 months of life, the child remained asymptomatic, with regression of retinochoroidal lesions and persistence of IgG. COMMENTS: It is possible that systematic neonatal screening in areas with high prevalence of infection may identify these cases.

PMID: 19918624 [PubMed - as supplied by publisher]