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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Congenital Toxoplasmosis in Tunisia: Prenatal and Neonatal Diagnosis and Postnatal Follow-up of 35 Cases
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Congenital Toxoplasmosis in Tunisia: Prenatal and Neonatal Diagnosis and Postnatal Follow-up of 35 Cases

机译：突尼斯先天性毒素病症：产前和新生儿诊断和产后后续35例

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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) Mand 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.
机译：先天性毒素病（CT）由毒素弓形虫的转血管通道转移到胎儿急性母体感染期间。我们的研究旨在报告在突尼斯的巴斯特研究所寄生虫学诊断的临床和生物学模式，并获得产前和早期后期诊断技术的表现。通过免疫球蛋白（IG）MARE IgG检测和IgG亲和力测定进行母体感染的血清学筛选。产前诊断基于羊水液和每月超声检查的弓形虫DNA检测。聚合酶链反应分析羊水液，仅在15例中进行，在五种情况下检测到弓形虫的DNA（33.3％）。超声检查没有揭示任何形态异常。三十名新生儿具有毒理学标准的弓形虫感染。 Immunoblot在23例（76.6％）中确诊先天性毒素诊断。在35名出生的婴儿中，五个（14.3％）是对症：三种临床眼科检查的肺病性炎，一个人患有神经系统症状（癫痫发作）脑脊髓阳性寄生虫DNA，并且患有眼科和神经系统损害脉络膜炎和计算机断层扫描中的颅内钙化。 35种感染儿童中有35个受感染的儿童用吡米达胺 - 磺胺扎嗪组合处理。由于治疗副作用，四（11.7％）的治疗婴儿表现出异常的血液学值。在七个婴儿中观察到血清学反弹。孕妇的筛查程序和诊断算法应在突尼斯实施，以改善血清政策的随访，防止CT病例。

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