Brade V, Engelhardt A, Harms D
Dtsch Med Wochenschr. 1987 May 22;112(21):837-41. doi: 10.1055/s-2008-1068150.
A newborn, delivered at term, developed a rapidly increasing hydrocephalus with intracranial calcifications and seizures during the first week of life. Clinical suspicion of congenital toxoplasmosis was at first not confirmed serologically (serum titer in the immunofluorescence test [IFT] of 1:1024 and complement-fixation reaction [CFR] of 1:40 equalling those of the mother; IgM-IFT being negative and the IFT and CFR titers significantly falling within two weeks). But in the further course of the disease the diagnosis of congenital toxoplasmosis was confirmed: 1. Microscopic tachyzoits in CSF when aged six weeks; 2. positive IgM-IFT in serum and CSF from the seventh weeks onwards; 3. steep IFT titer rise in serum and CSF from the 16th week onwards. This case demonstrates that with delayed immune response in the infected child only serial serological tests will exclude or confirm the diagnosis of congenital toxoplasmosis.
一名足月出生的新生儿在出生后第一周出现脑积水迅速加重、颅内钙化并伴有癫痫发作。起初，临床怀疑先天性弓形虫病，但血清学检查未得到证实（免疫荧光试验[IFT]血清滴度为1:1024，补体结合反应[CFR]为1:40，与母亲的滴度相同；IgM-IFT为阴性，且IFT和CFR滴度在两周内显著下降）。但在疾病的进一步发展过程中，先天性弓形虫病的诊断得到了证实：1. 六周龄时脑脊液中发现显微镜下的速殖子；2. 从第七周起血清和脑脊液中IgM-IFT呈阳性；3. 从第16周起血清和脑脊液中IFT滴度急剧上升。该病例表明，在受感染儿童免疫反应延迟的情况下，只有通过系列血清学检查才能排除或确诊先天性弓形虫病。
