Sato Shimpei, Nishida Masakazu, Nasu Kaei, Narahara Hisashi, Norose Kazumi, Aosai Fumie
Department of Obstetrics and Gynecology, Nakatsu Municipal Hospital, Oita, Japan.
J Obstet Gynaecol Res. 2014 Nov;40(11):2158-61. doi: 10.1111/jog.12477. Epub 2014 Aug 28.
A 33-year-old woman with type 2 diabetes mellitus (DM) was suspected of being primarily infected with Toxoplasma gondii at 12 weeks of gestation (GW). Although acetylspiramycin was started at 17 GW, the T. gondii DNA gene was detected in the amniotic fluid at 18 GW. Chemotherapy was changed to pyrimethamine plus sulfadiazine from 20 GW, but was changed back to acetylspiramycin after 2 weeks because of vomiting. Acetylspiramycin was continued until her delivery. DM was controlled well during the pregnancy. An asymptomatic male baby was born by cesarean section at 37 GW, and was treated with acetylspiramycin for 4 weeks because the polymerase chain reaction results of umbilical cord blood were positive. He has developed normally until the present, that is, 6 months of age. Herein, we describe a case report in which symptomatic congenital toxoplasmosis was avoided in a pregnant woman with an immunosuppressive risk due to prompt chemotherapy.
一名33岁的2型糖尿病女性在妊娠12周时被怀疑初次感染弓形虫。尽管在妊娠17周时开始使用乙酰螺旋霉素,但在妊娠18周时羊水检测出弓形虫DNA基因。从妊娠20周起化疗改为乙胺嘧啶加磺胺嘧啶,但2周后因呕吐又换回乙酰螺旋霉素。乙酰螺旋霉素持续使用至分娩。孕期糖尿病控制良好。一名无症状男婴在妊娠37周时剖宫产出生,因脐带血聚合酶链反应结果呈阳性,接受乙酰螺旋霉素治疗4周。截至目前,即6个月大时,他发育正常。在此,我们报告一例病例,由于及时化疗,一名有免疫抑制风险的孕妇避免了出现症状性先天性弓形虫病。