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Prognosis of pregnancy in patients with toxoplasmic retinochoroiditis.

From the study of 18 pregnancies in 10 patients with toxoplasmic retinochoroiditis, it was concluded that the most important factor to be considered in advising pregnant patients with this disease is whether or not the antibody titer increases during pregnancy rather than the clinical pictures or the absolute values of antibody titer. Periodical titration of the antitoxoplasma antibody during pregnancy was recommended as a preventive measure against congenital toxoplasmosis. Pregnancy may be continued if antibody titer does not increase during pregnancy, and it may be interrupted if the antibody titer increases.

Adolescent↗

Intraocular inflammatory disorders: uveitis.

Emphasis on the association between intraocular inflammatory disorders and systemic disease guides the clinical descriptions of acute and chronic uveitis in this article. Practical information on establishing the diagnosis and treating the condition is provided.

Acute Disease↗

Acute acquired toxoplasmosis.

A case of acute necrotizing retinitis with discrete involvement in the right posterior pole was followed undiagnosed until the patient developed endophthalmitis in the right eye, loss of consciousness, high fever, and a similar picture in the left eye. Treatment with sulfadiazine, pyrimethamine, and steroids brought about a prompt resolution. When the patient died from an unrelated cause, histopathology was performed showing Toxoplasma gondii in the brain.

Brain Diseases↗

Uveitis.

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Animals↗

A new complement fixation test for toxoplasmosis. Comparison with other serological methods.

A new complement fixation test for toxoplasmosis has been compared with the classical test indirect immunofluorescence test (IFAT) and indirect haemoagglutination test (IHAT). Neither false positive or negative results were obtained with LBCF-H100-TTE. Notably these values correlate well with IFA titers. Furthermore LBCF-H100-TTE shows the highest titers in acute cases and its time course is practically superimposable to IFAT. The differences obtained performing these different tests on the preferential detection of different antigen antibodies systems by these 3 tests are discussed.

Complement Fixation Tests↗

Congenital toxoplasmosis: long-term follow-up.

The incidence in Europe is high, about 6 in 1000 births. Five percent of these babies either die or are severely damaged by the disease. In the others most infections are clinically asymptomatic in the neonatal period. In +/- 70% of all infants with congential infections relapses of chorioretinitis give rise to scars in their eyes after a follow-up of 16 years. The relapses were occurring later on both in treated and untreated infants. Most scars were in the periphery of the retina, but scars in the neighbourhood of the macula can threaten the vision. In 1--2% of these children later on uveitis impairing vision due to congenital toxoplasmosis will occur. As a control 117 children in the age 12--14 years without congenital toxoplasmosis were studied. No chorioretinitis-scars were found in the eyes although +/- 50--60% had antibodies against toxoplasmosis, resulting from an acquired infection. The problem of prevention is unsolved. There is no vaccine. Deliberately infecting girls before pregnancy is too dangerous. Screening of pregnant women is possible but no clear-cut safe therapy is available. Screening of the baby after birth is too late.

Adolescent↗

[The effectiveness of a general test for Toxoplasma gondii infection in pregnancy].

Primary toxoplasma gondii infection in pregnancy (6.7 per thousand pregnancies) is considered to be a potential danger to foetal development (congenital infections in 5.3 per thousand). This conclusion had been drawn from a prospective study into 1,697 pregnant women. It is a primary infection which can be detected only by means of specific diagnostic methods. - Pyrimethamine-sulphonamide treatment ,ist be considered as the optional for pregnant women, even by all accounts of side-effects. The risk of foetal infection has been reduced from 64 to 14 per cent by use of such treatment on cases of primary infection. - The results so far obtained from examination of congenitally infected children, aged between nine and ten years, are likely to justify the recommendation of general toxoplasma gondii testing and specific therapy for all cases of primary infection during pregnancy.

Adolescent↗