Department of Academic Paediatrics, Imperial College London, London, UK
Vaccines & Immunity Theme, MRC The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia.
Arch Dis Child Educ Pract Ed. 2020 Oct;105(5):262-269. doi: 10.1136/archdischild-2018-316603. Epub 2020 Feb 18.
Congenital toxoplasmosis occurs following transplacental transfer of Irrespective of symptom status at birth, infants with congenital infection may develop serious long-term sequelae, including learning disability, seizures, hydrocephalus, motor and hearing deficits, chorioretinitis and retinal scarring with impaired vision. Timely diagnosis facilitates early initiation of therapy, aimed at prevention or amelioration of adverse clinical consequences. Diagnosis can be difficult, however, since acutely infected mothers are often asymptomatic and laboratory testing can be complex. Moreover, any decision to start treatment in the newborn must include careful consideration of the benefits and risks. This paper outlines a structured approach for managing an infant born to a woman with possible or confirmed infection during pregnancy, including key aspects of the antenatal history, interpretation and timing of investigations, treatment and appropriate follow-up. Our recommendations are based on current evidence in the literature, consensus from two UK paediatric infectious disease centres and the UK specialist Toxoplasma Reference Unit.
先天性弓形虫病是通过胎盘转移发生的。无论出生时的症状状态如何，患有先天性感染的婴儿可能会出现严重的长期后遗症，包括学习障碍、癫痫、脑积水、运动和听力缺陷、脉络膜视网膜炎和视网膜瘢痕导致视力受损。及时诊断有助于早期开始治疗，旨在预防或改善不良临床后果。然而，诊断可能很困难，因为急性感染的母亲通常无症状，实验室检测可能很复杂。此外，任何在新生儿中开始治疗的决定都必须仔细考虑利弊。本文概述了一种针对孕妇可能或确诊感染弓形虫病的婴儿的管理方法，包括产前史、检查的解释和时机、治疗和适当的随访等关键方面。我们的建议基于文献中的现有证据、来自英国两家儿科传染病中心和英国专业弓形虫参考单位的共识。
