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胎儿和新生儿弓形虫病:患病率、诊断和治疗的最新进展。

Toxoplasmosis in the fetus and newborn: an update on prevalence, diagnosis and treatment.

机构信息

Department of Medicine and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Expert Rev Anti Infect Ther. 2012 Jul;10(7):815-28. doi: 10.1586/eri.12.58.

Abstract

Toxoplasma gondii is an unicellular coccidian parasite with worldwide distribution. It is estimated that more than a third of the world's population has been infected with the parasite, but seroprevalence is unevenly distributed across countries and different socioeconomic strata. The majority of newborns with congenital toxoplasmosis do not have any clinical signs of the disease at birth; however, 30-70% of those with clinical abnormalities were not detected initially, and are found to have new retinal lesions consistent with toxoplasmicchorioretinitis later in life. Congenital toxoplasmosis can also cause fetal death, stillbirths or long-term disabling sequelae, particularly among untreated infants. The disease appears to be more frequent and severe at certain latitudes. Congenital toxoplasmosis can be prevented and treated during gestation. Less severe disease is commonly reported in countries where prenatal screening and treatment have been systematically implemented. By contrast, severe disease appears to be observed primarily in infants born to untreated mothers. For definition purposes, it is best to use the term toxoplasma or Toxoplasma gondii infection when referring to asymptomatic patients with primary or chronic infection, and toxoplasmosis when referring to patients with symptoms or signs.

摘要

刚地弓形虫是一种具有全球分布的单细胞球虫寄生虫。据估计,全世界超过三分之一的人口已被该寄生虫感染,但血清阳性率在各国和不同社会经济阶层之间分布不均。大多数先天性弓形虫病新生儿出生时没有任何疾病迹象;然而,最初未检测到 30-70%有临床异常的新生儿,后来在生活中发现与弓形虫脉络膜视网膜炎一致的新视网膜病变。先天性弓形虫病还可导致胎儿死亡、死产或长期致残后遗症,尤其是在未经治疗的婴儿中。在某些纬度,该病似乎更为频繁和严重。先天性弓形虫病可在妊娠期间预防和治疗。在已系统实施产前筛查和治疗的国家,通常报告病情较轻。相比之下,严重疾病似乎主要发生在未经治疗的母亲所生的婴儿中。为了定义目的,最好在提到原发性或慢性感染的无症状患者时使用术语弓形虫或刚地弓形虫感染,而在提到有症状或体征的患者时使用弓形虫病。

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