Briese V, Rogmann K, Müller H, Plesse R
Frauenklinik, Universität Rostock.
Zentralbl Gynakol. 1995;117(11):578-84.
Over a period of eight years, 61 patients with toxoplasmosis infection in pregnancy were examined retrospectively at women's hospital. Diagnosis of maternal infection was based on seroconversion, positive IgM, raising IgG--titers above twofold, and very high primary titers in SFT. In 20 patients (32.8%) diagnosis was found with seroconversion. In 15 patients (24.6%) the first examination revealed very high titers (SFT > or = 1:2000, KBR > or + 1:40)> Using a score, time of infection was grouped into: periconceptional (24.59%), 1st Trimester (34.43%) 2nd Trimester (31.14%), 3rd Trimester (4.92%), not specified (4.92%). The latency phase between first suspect titer and treatment did vary markedly. Duration of latency phase was longer than 6 weeks only in 10% and 20% of cases identified via seroconversion or very high titers respectively. Of all cases with different diagnostic attempts 73.9% were treated later than 6 weeks after the first suspect titer. Therapy was performed with either a combination of pyrimethamine-sulfadiacine or spiramycin monotherapy. In 18/53 newborns (33.9%) fetal infections were proven with IgM-detection post partum. Clinical evaluation was normal in 48 children (77.5%). 6 newborns (9.7%) had dilated cerebral ventricles; 3 (4.8%) had irregularly dense intracerebral structures, one newborn (1.6%) had intracerebral calcifications. Primary neurological check-up of the newborn was normal in 91.9%. 2 children (3.2%) had facial paralysis or reduced muscle tonus. In 2 newborns (3.2%) opthalmological examination of the fundus revealed signs of retino-chorioditis.
在八年的时间里,对妇女医院61例孕期弓形虫感染患者进行了回顾性检查。母体感染的诊断基于血清转化、IgM阳性、IgG滴度升高两倍以上以及SFT中非常高的初始滴度。20例患者(32.8%)通过血清转化确诊。15例患者(24.6%)首次检查时发现滴度非常高(SFT≥1:2000,KBR≥1:40)。使用一个评分系统,将感染时间分为:受孕前后(24.59%)、孕早期(34.43%)、孕中期(31.14%)、孕晚期(4.92%)、未明确(4.92%)。首次可疑滴度与治疗之间的潜伏期差异显著。仅分别通过血清转化或非常高的滴度确诊的病例中,潜伏期超过6周的分别仅占10%和20%。在所有进行了不同诊断尝试的病例中,73.9%在首次可疑滴度后6周以上才接受治疗。治疗采用乙胺嘧啶 - 磺胺嘧啶联合用药或螺旋霉素单药治疗。在53例新生儿中的18例(33.9%)产后通过IgM检测证实有胎儿感染。48名儿童(77.5%)的临床评估正常。6例新生儿(9.7%)有脑室扩张;3例(4.8%)有脑内结构密度不规则;1例新生儿(1.6%)有脑内钙化。新生儿的初次神经系统检查91.9%正常。2名儿童(3.2%)有面瘫或肌张力降低。2例新生儿(3.2%)眼底眼科检查发现视网膜脉络膜炎迹象。