Toxoplasmosis and eye diseases in children

The frequency of toxoplasmosis varies widely in different geographical regions. In some countries, toxoplasmosis is extremely common, and in others it is rare. After the birth of a child, toxoplasmosis causes fever and lymphadenopathy, which is not of significant clinical significance. However, with the disease of a pregnant woman, toxoplasmosis often causes significant damage to the developing fetus. The emergence of an infection, especially severe, in the first third of pregnancy can lead to the death of the embryo. The later the infectious process develops and the easier it is for the mother, the less significant consequences it leaves. A relatively small number of infected mothers have affected children.

The syndrome of congenital toxoplasmosis includes:

• intracranial calcification;
• hydrocephalus;
• microcephaly;
• convulsions;
• hepatitis;
• fever;
• anemia;
• loss of hearing;
• mental retardation.

Manifestations of the syndrome of congenital toxoplasmosis from the side of the organ of vision include:

• chorioretinitis;
• uveitis;
• cortical blindness;
• cataract (secondary to uveitis).

Chorioretinitis

Chorioretinitis is the most common manifestation of the syndrome of congenital toxoplasmosis, manifested by the appearance of limited foci of chorioretinal atrophy and hyperpigmentation. The process, as a rule, is two-sided, with predominant localization at the posterior pole of the eye. Exacerbations of uveitis are possible at any time during the entire subsequent life.

Another pathology of the organ of vision

In severe clinical manifestations of congenital toxoplasmosis syndrome, microphthalmos, cataracts and panoveitis may occur. Cataracts are usually a nonspecific consequence of the intraocular inflammatory process and almost always combine with severe retinal pathology. Atrophy of the optic nerve may be due to hydrocephalus or other brain lesions.

Diagnosis of toxoplasmosis

The diagnosis, as a rule, is established through serological examination. The results of the Dye test (Dye) depend on the degree of inhibition of live Toxoplasma gondii antibodies in the serum of the patient. With an acute process, the titles of the Dye test are enhanced. Since the serum of a baby can contain passively produced antibodies, a high antibody titer or positive results occur in determining the specific immunoglobulin IgM in the enzyme-linked immunosorbent assay.

[1], [2], [3], [4], [5], [6], [7]

Treatment of toxoplasmosis

Positive serological results in newborns suffering from toxoplasmosis in the presence of a specific immunoglobulin IgM are an indication for the appointment of pyrimethamine at a daily dose of 1 mg / kg of weight and sulfadiazine at a daily dose of 100 mg / kg of weight in combination with folic acid for 2-3 weeks . Primarily infected pregnant women are prescribed spiramycin, but the use of pyrimethamine and sulfadiazine is not recommended.

The feasibility of screening for toxoplasmosis is still controversial. Screening for this pathology is more relevant in countries endemic for this disease.

Patients with cataracts to determine the functional prognosis of a surgical procedure are given an ultrasound examination, a study of visual evoked potentials, and electroretinography. With exacerbations of chorioretinitis, the general use of steroid drugs and pyrimethamine or spiramycin is prescribed. Children with congenital toxoplasmosis syndrome are treated with a child infectious disease specialist.