Garin J P, Mojon M, Piens M A, Chevalier-Nuttall I
Laboratoire de parasitologie, Faculté de médecine et de pharmacie, Lyon, France.
Pediatrie. 1989;44(9):705-12.
A protocol of monitoring and treatment in toxoplasmosis is suggested by the authors. During pregnancy, the administration of spiramycine at a 9 m UI daily dose remains the basic preventive treatment when a seroconversion occurs after a 4 week post-conception period. In the fetus, the antenatal diagnosis is made by ultrasound started on the 18th week after conception and repeated every 4 weeks, amniocentesis and eventually umbilical cord puncture associated with a pyrimethamine-sulfamide drug treatment in case of positive diagnosis. A therapeutic pregnancy termination is considered when lesions have been detected by ultrasound. In the newborn (neonatal or post-natal period), the diagnosis is made by transfontanel ultrasonography, ocular fundi and spinal fluid examination, detection of specific IgM antibodies in cord blood and the evolution and importance of serum antibodies response requiring a drug treatment during 15-18 months with spiramycine and pyrimethamine + sulfadoxine (Fansidar).
作者提出了一份弓形虫病的监测与治疗方案。在孕期，当受孕后4周出现血清转化时，每日900万国际单位的螺旋霉素给药仍是基本的预防性治疗。对于胎儿，产前诊断通过在受孕后第18周开始的超声检查进行，每4周重复一次，进行羊膜穿刺术，若诊断为阳性，最终进行脐带穿刺并联合乙胺嘧啶 - 磺胺药物治疗。当超声检测到病变时，考虑终止妊娠。在新生儿期（新生儿期或出生后期），通过前囟超声检查、眼底和脑脊液检查、检测脐血中特异性IgM抗体以及血清抗体反应的演变和重要性进行诊断，这需要用螺旋霉素和乙胺嘧啶 + 磺胺多辛（Fansidar）进行15 - 18个月的药物治疗。
