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PubMed1991

[Embryofetal diseases in the tropical zone].

The treatment and the prevention of acquired fetal diseases in developing countries are difficult. Nevertheless the deleterious consequences of fever, alcohol consumption, drug intake and malaria on the embryo and the foetus can be avoided by appropriate measures. As for the prevention and the diagnostic in utero of rubella and toxoplasmosis, they may be considered lately when the current priority objectives of public health are reached. Epidemiological studies on these diseases are therefore justified.

Bacterial Infections↗
PubMed1982

[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↗
PubMed2004

Cultured embryonic retina systems as a model for the study of underlying mechanisms of Toxoplasma gondii infection.

PURPOSE: Toxoplasma gondii, the most common cause of retinochoroiditis in humans, is an obligate intracellular protozoan parasite that depends on te host cell's microenvironment to proliferate. Because congenital infection is associated with a higher risk of ocular involvement than a postnatally acquired infection, this study was conducted to investigate the ability of Toxoplasma gondii to infect retinal tissue during development, when cellular environmental changes normally occur. METHODS: Retinas from 5- to 9-day-old chick embryos were used. Stationary cultures were prepared in 24-well cell culture dishes and maintained at 37 degrees C in DMEM plus 5% fetal bovine serum for 2 to 6 days. Then the wells were infected with 4 x 10(5) tachyzoites. Retina explants and aggregate cell cultures were maintained in DMEM under rotation at 37 degrees C. T. gondii proliferation was measured using [(3)H]-thymidine incorporation after 72 hours. Ornithine and arginine decarboxylase (ODC and ADC) activities were determined by measuring CO(2) production from [1-(14)C]-ornithine and [1-(14)C]-arginine, respectively. RESULTS: The proliferation of tachyzoites was high in dense, stationary cultures expressing elevated ODC and ADC activity. The addition of ODC or ADC inhibitors reduced T. gondii proliferation by approximately 20% to 40%. As for cultured retina cells, retina explants also allowed T. gondii proliferation whenever ODC activity was high. CONCLUSIONS: The data suggest a direct correlation between retinal polyamine biosynthesis and the proliferation of T. gondii, in agreement with the observation that individuals infected congenitally have a greater risk of development of toxoplasmic retinochoroiditis.

Animals↗
PubMed1991

Identification of Toxoplasma gondii infections by BI gene amplification.

The diagnosis of toxoplasmosis in congenitally infected children or in immunocompromised patients can be difficult; serology is not reliable, and the diagnosis must be based on the combination of symptomatology and the direct demonstration of the parasite in clinical specimens by microscopy, antigen detection, or inoculation of samples into mice or tissue cultures. These techniques are either insensitive or time-consuming. To determine the value of the polymerase chain reaction (PCR) for the diagnosis of Toxoplasma gondii infections, we compared this technique with conventional detection techniques, such as microscopy, tissue culturing, and mouse inoculation. We were able to detect T. gondii by PCR in clinical specimens and tissue samples that were obtained postmortem from a bone marrow recipient with cerebral toxoplasmosis and from three congenitally infected children. The presence of T. gondii was demonstrated in brain tissue, cerebrospinal fluid, the heart, and skeletal muscle tested fresh or after fixation in Formalin. In only one sample was T. gondii isolated by mouse inoculation but not detected by PCR. Because it is a sensitive, relatively rapid, and specific method and because it can be applied to a variety of different clinical samples, PCR can be considered a valuable additional tool for the identification of T. gondii infections.

Adult↗
PubMed2003

Lenticulostriate echogenic vessels: clinical and sonographic study of 70 neonatal cases.

BACKGROUND: Neonatal branching echogenic streaks in the basal ganglia or 'lenticulostriate vasculopathy' (LSV) has no clear comprehensive aetiology. OBJECTIVE: To provide some clinical evidence, possibly relevant to aetiology, by analysis of a large series. MATERIALS AND METHODS: Seventy cases (9 deaths, 3 post mortem) identified between 1981 and 2000 out of 9,138 neonates with routine brain sonograms (578 in a protocol for neonates from HIV+ mothers). Review of maternal/neonatal charts for clinical data and serologic status. Retrospective analysis of sonograms for grading and time course of LSV and coexistent abnormalities. RESULTS: LSV was unilateral in 31 cases (22 right), bilateral in 39. Grading separated 8 major, 27 moderate and 35 minor patterns. In 42 cases, LSV was isolated, and in 28 it was mixed with peri-intraventricular haemorrhage grades I or II and/or leucomalacia. LSV was detected in the first postnatal week in 56 instances and appeared later in 13. Disappearance occurred mostly within 2 months. Perinatal circumstances: 13 recipient monochorionic twins (polycythaemia from twin-twin transfusion syndromes), 20 HIV+ mothers (possible immunological disturbances; only 2 infected neonates), 10 congenital anomalies, 1 toxoplasmosis, 1 postnatal cytomegalovirus infection, 25 miscellaneous conditions. Numerous maternal and neonatal factors were non-contributory. CONCLUSIONS: These results do not support congenital toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH) infections as the main causative factor. Polycythaemia and various immunological disturbances may be involved, as well as infectious agents not appropriately screened by routine serodiagnoses.

Adult↗
PubMed1989

Ocular toxoplasmosis; common and rare symptoms and signs.

The common and rare symptoms and signs of congenital, childhood and adult ocular toxoplasmosis are discussed together with the differential diagnosis of the retinal lesions. A choroidal coloboma in connection with congenital toxoplasmosis is described. The occurrence of an optic pit with congenital macular toxoplasmosis, growth of subretinal new vessels as well as disappearance of arteriolar and venular sheathing is demonstrated.

Adult↗
PubMed1980

The Aicardi syndrome versus congenital infection: diagnostic considerations.

The Aicardi syndrome consists of agenesis of the corpus callosum, infantile spasms, a characteristic lacunar chorioretinopathy, mental subnormality, and costovertebral anomalies. All patients have been female. Its clinical similarity to several congenital intrauterine infections, particularly toxoplasmosis, is reinforced by the erroneous diagnosis of congenital infection initially made in the two patients reported here. Reasons for this confusion are outlined, and methods for a clinical differentiation between the Aicardi syndrome and the congenital infections are discussed.

Abnormalities, Multiple↗
PubMed1995

Value of specific immunoglobulin A detection by two immunocapture assays in the diagnosis of toxoplasmosis.

The diagnosis of Toxoplasma gondii infection is currently based on immunological tests, but tests for IgG and IgM antibodies alone are often insufficient to assess the risk of active disease, especially during pregnancy and in immunodeficient subjects. The supplementary diagnostic value of testing for antitoxoplasmic IgA in cases of acute, chronic, congenital and reactivated toxoplasmosis, relative to classical immunological tests, was evaluated using two immunocapture tests, one based on tachyzoite agglutination and the other on an immunoenzymatic complex recognizing the membrane protein P30 of Toxoplasma gondii. A total of 4,541 sera from 395 uninfected subjects, 468 immunized subjects with chronic infection, 117 subjects with acute infection and 403 children, 103 of whom had congenital toxoplasmosis, was tested. Specific IgA tests were negative in the nonimmune population, but tests for this immunoglobulin subtype became positive very rapidly during primary infection, and IgA disappeared more rapidly than IgM. In the children infected in utero, specific IgA was detected more frequently than IgM. In contrast, in a population of HIV-seropositive subjects with clinical toxoplasmosis, tests for IgA were poorly sensitive. The two tests for specific IgA produced similar results, except in the early stages of primary infection, in which immunoenzymatic testing for anti-P30 IgA was less sensitive than the agglutination method.

Agglutination Tests↗
PubMed1987

Four factors that accurately predict hearing loss in "high risk" neonates.

Two simple overall measures of health--length of stay in the Intensive Care Nursery (ICN) and gestational age--predict hearing loss in ICN graduates. Craniofacial anomalies, congenital perinatal infections, and meconium aspiration are strong predictors of hearing loss, especially in term infants. Findings are based on univariate and multivariate analyses of a number of variables that might be associated with permanent hearing loss. Study variables included all seven High Risk Register items and a number of other features of the ICN history. They were examined in 799 ICN graduates whose hearing had been monitored in their first few years of life. These babies composed 40% of the ICN population and were selected because they had one or more "high risk" factors in their neonatal history. Prevalence of hearing loss in this high risk sample was similar to that found in other ICN samples. Prevalence of hearing loss associated with individual Risk Register items was similar to other published findings for some items and not for others.

Birth Weight↗
PubMedDate not supplied

Chronic congenital infections of man.

This discussion focuses on the dynamic nature of three chronic congenital infections of man, namely those caused by cytomegaloviruses, rubella virus, and Toxoplasma gondii. The spectra of the fetal infection are described and the risks associated with the acute and chronic phases of the fetal infections are contrasted. Because of their frequency and subtlety, emphasis is placed on the late-appearing sequelae which are associated with the persistent and/or recurring aspects of these infections.

Central Nervous System Diseases↗
PubMed1996

Screening for toxoplasmosis in pregnancy: what is the evidence of reducing a health problem?

OBJECTIVES: Toxoplasma gondii is a parasite which may give rise to congenital infection. Screening pregnant women for antibodies against toxoplasmosis is being debated in many countries. The preventive impact of toxoplasmosis screening of pregnant women depends on the magnitude of disease caused by congenital toxoplasmosis (incidence x transmission rate to fetus x diseased proportion of infected children), on the one hand, and the preventable proportion of disease (sensitivity of the screening test x efficacy of the treatment x compliance), on the other. In this study the preventive impact of screening pregnant women for toxoplasmosis antibodies is assessed by letting the value for these variables change within reasonable limits. METHODS: To obtain information on these variables, relevant publications were reviewed in the Medline database from 1983 to February 1996 and the Cochrane Pregnancy and Childbirth Database. References in review articles on congenital toxoplasmosis were also studied. RESULTS: The literature review showed that no population based prospective studies of the natural history of toxoplasmosis infection during pregnancy, nor any randomised controlled trials of the efficacy of antiparasitic treatment, had been carried out. In the empirical studies which have been performed the values of most variables show considerable differences. According to these values, the estimates in this study of the impact of toxoplasmosis screening in pregnancy may range from 0 to 40 children in whom disease is preventable per 100,000 pregnant women susceptible to toxoplasmosis infection. CONCLUSION: Sufficient scientific evidence is not yet available to propose screening for toxoplasmosis in pregnant women, and efforts should be made to provide such knowledge. Also, the magnitude of the negative impact of screening, such as induced abortion of healthy fetuses, anxiety in women with false positive screening tests, and side effects of treatment, has not been sufficiently examined.

Antiprotozoal Agents↗
PubMed1999

Toxoplasma gondii antibody titers in sera of children admitted to the Seoul National University Children's Hospital.

A total of 542 children under 10 years of age, admitted to the Seoul National University Children's Hospital, was examined for antibody titers of Toxoplasma gondii using indirect latex agglutination (ILA) test. Among them, 7.7% showed positive titers higher than 1:32, without significant difference between males (7.3%) and females (8.5%). The seropositive rate increased with age although the statistical significance was negligible (0.05 < P < 0.1). By residential areas, the prevalence appeared higher among children from southern provinces (Kyongsang-do and Cholla do) than those from other areas, but the statistical significance was also very low (0.05 < P < 0.1). When the seropositive cases were analyzed by coincidental diseases, the prevalence was significantly higher in patients with congenital diseases than in patients with non-congenital diseases (P < 0.05). The results showed that the seropositive rate of toxoplasmosis in children examined was not high compared with other endemic countries. Some correlations are suggested between toxoplasmosis and congenital anomalies in Korea.

Animals↗