Too late prenatal diagnosis of fetal toxoplasmosis: a case report.
OBJECTIVE
We describe a case of severe fetal hydrocephalus due to toxoplasmosis which could not be diagnosed until late gestational age due to the lack of a serologic surveillance program during pregnancy; moreover, this case points to the usefulness of molecular biology tools in the diagnostic process. Abnormal ultrasound in the 2nd trimester was noticed and Toxoplasma gondii was demonstrated in amniotic fluid at the 28th week of gestation both by PCR and by mice inoculation. Fansidar and folinic acid were administered. The newborn suffered from progressive hydrocephalus, seizures, and pathological muscular tonus; ultrasound examination showed massive cerebral calcifications. Ophthalmologic examination revealed bilateral choroidoretinitis. Congenital toxoplasmosis was confirmed by the detection of anti- T. gondii IgM and IgA in the neonatal serum.


CONCLUSIONS
The presented case is an example of severe fetal toxoplasmosis diagnosed and treated in utero.
Nowakowska
Dorota
D
Department of Fetal Maternal Medicine, Research Institute Polish Mother's Memorial Hospital, Lodz, Poland. dnowakowska@hotmail.com
Respondek-Liberska
Maria
M
Golab
Elzbieta
E
Stray-Pedersen
Babill
B
Szaflik
Krzysztof
K
Dzbenski
Tadeusz H
TH
Wilczynski
Jan
J
D000328:Adult; D000653:Amniotic Fluid / Q000469:parasitology; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000469:parasitology; D002114:Calcinosis / Q000469:parasitology; D002833:Choroiditis / Q000469:parasitology; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000469:parasitology*; D007070:Immunoglobulin A / Q000032:analysis / Q000276:immunology; D007075:Immunoglobulin M / Q000032:analysis / Q000276:immunology; D007231:Infant, Newborn; D002955:Leucovorin / Q000627:therapeutic use; D051379:Mice; D009135:Muscular Diseases / Q000469:parasitology; D011247:Pregnancy; D011739:Pyrimethamine / Q000627:therapeutic use; D012173:Retinitis / Q000469:parasitology; D012640:Seizures / Q000469:parasitology; D012720:Severity of Illness Index; D013413:Sulfadoxine / Q000627:therapeutic use; D013997:Time Factors; D014122:Toxoplasma / Q000276:immunology / Q000302:isolation & purification; D014125:Toxoplasmosis, Congenital / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016216:Ultrasonography, Prenatal
D000981:Antiprotozoal Agents; D004338:Drug Combinations; D007070:Immunoglobulin A; D007075:Immunoglobulin M; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002955:Leucovorin; D011739:Pyrimethamine