先天性弓形虫病
Congenital toxoplasmosis.
作者信息
Martin S
机构信息
University of Tennessee Medical Center, Knoxville, USA.
出版信息
Neonatal Netw. 2001 Jun;20(4):23-30. doi: 10.1891/0730-0832.20.4.23.
Toxoplasma gondii, a parasite, has three modes of transmission: oral intake of raw or undercooked meat or contaminated fruits and vegetables, ingestion of materials contaminated with cat feces, and transplacental infection. The focus of this article is congenital toxoplasmosis, which is transmitted to the fetus across the placenta. When primary infection of the mother occurs during pregnancy, there is a 40 percent chance of fetal infection; rate of transmission and severity of infection are related to gestational age at the time of infection. The brain and retina are often affected, and there can be a wide range of clinical disease. Amniocentesis or cordocentesis provides the most accurate diagnosis. At birth, 80-90 percent of infants with congenital toxoplasmosis are asymptomatic. But further testing may reveal retinal and central nervous system abnormalities, and there is a risk of long-term sequelae. Chorioretinitis, hydrocephalus, intracranial calcifications, and convulsions are the typical presentation of classic congenital toxoplasmosis. Serology is the most common method of diagnosing neonatal infection, but more complex tests are also utilized. The prognosis for the untreated infant is poor; however, when antibiotic therapy is started early, the rate of sequelae is reduced significantly.
弓形虫是一种寄生虫,有三种传播方式:经口摄入生的或未煮熟的肉类或受污染的水果和蔬菜、摄入被猫粪便污染的物质以及经胎盘感染。本文的重点是先天性弓形虫病,它通过胎盘传播给胎儿。当母亲在孕期发生初次感染时,胎儿感染的几率为40%;传播率和感染严重程度与感染时的孕周有关。大脑和视网膜常受影响,临床疾病表现广泛。羊膜腔穿刺术或脐血穿刺术可提供最准确的诊断。出生时,80% - 90%的先天性弓形虫病婴儿无症状。但进一步检查可能会发现视网膜和中枢神经系统异常,且存在长期后遗症的风险。脉络膜视网膜炎、脑积水、颅内钙化和惊厥是典型先天性弓形虫病的典型表现。血清学是诊断新生儿感染最常用的方法,但也会采用更复杂的检测。未经治疗的婴儿预后较差;然而,早期开始抗生素治疗可显著降低后遗症发生率。