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产科医生应知晓:妊娠期抗生素弓形虫病治疗的严重副作用。

What obstetricians should be aware of: serious side effects of antibiotic toxoplasmosis treatment in pregnancy.

机构信息

Department of Obstetrics and Gynecology, Cantonal Hospital Lucerne, Luzern, Switzerland

Department of Obstetrics and Gynecology, Cantonal Hospital Lucerne, Luzern, Switzerland.

出版信息

BMJ Case Rep. 2021 Mar 1;14(3):e240809. doi: 10.1136/bcr-2020-240809.

Abstract

Infection with is usually an asymptomatic or oligosymptomatic, self-limiting disease in immunocompetent individuals. However, during the pregnancy, primary infection can lead to transplacental vertical transmission resulting in congenital toxoplasmosis with possible severe sequelae. The efficacy of systematic screening remains controversial and the effect of antibiotic treatment is unclear. Although main side effects of antibiotic drugs used for toxoplasmosis are well known, mostly from malaria treatment, there is a lack of information about occurrence in pregnant woman treated for toxoplasmosis. We report a case of a healthy pregnant woman with primary toxoplasmosis infection in the second trimester, who developed a severe adverse reaction in form of hypersensitivity pneumonia after antibiotic treatment with pyrimethamine and sulfadiazine and discuss the literature.

摘要

弓形虫感染在免疫功能正常的个体中通常为无症状或症状较轻、自限性疾病。然而,在怀孕期间,初次感染可能导致经胎盘垂直传播,从而导致先天性弓形虫病,并可能产生严重的后遗症。系统筛查的效果仍存在争议,抗生素治疗的效果也不明确。尽管用于治疗弓形虫病的抗生素药物的主要副作用众所周知,主要来自疟疾治疗,但关于在接受弓形虫病治疗的孕妇中发生的副作用的信息却很缺乏。我们报告了一例健康孕妇在妊娠中期初次感染弓形虫,在接受乙胺嘧啶和磺胺嘧啶抗生素治疗后发生严重的过敏反应性肺炎,并对文献进行了讨论。

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本文引用的文献

1
Treatment of toxoplasmosis: Current options and future perspectives.弓形虫病的治疗:当前选择与未来展望
Food Waterborne Parasitol. 2019 Apr 1;15:e00036. doi: 10.1016/j.fawpar.2019.e00036. eCollection 2019 Jun.
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Congenital Toxoplasmosis.先天性弓形虫病
J Pediatric Infect Dis Soc. 2014 Sep;3 Suppl 1(Suppl 1):S30-5. doi: 10.1093/jpids/piu077.
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The Austrian Toxoplasmosis Register, 1992-2008.奥地利弓形体病登记处,1992-2008 年。
Clin Infect Dis. 2015 Jan 15;60(2):e4-e10. doi: 10.1093/cid/ciu724. Epub 2014 Sep 12.
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Congenital toxoplasmosis treatment.先天性弓形虫病的治疗。
Eur Rev Med Pharmacol Sci. 2011 Feb;15(2):193-8.

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