先天性弓形虫病相关流产合并妊娠前四个月母体感染 1 例。
A case of congenital toxoplasmosis-associated miscarriage with maternal infection four months prior to conception.
机构信息
Service de Parasitologie-Mycologie, CHU de Nice, Université Côte d'Azur, Nice, France; Inserm U1065, C3M, Nice, France.
Service de Gynécologie-Obstétrique, CHU de Nice, Nice, France.
出版信息
Parasitol Int. 2020 Dec;79:102165. doi: 10.1016/j.parint.2020.102165. Epub 2020 Jun 24.
BACKGROUND
We report a case of fatal congenital toxoplasmosis with maternal infection dated four months before pregnancy in the absence of any specific immunosuppressive condition.
CASE
Ms. D. experienced submaxillary lymphadenitis in February 2018. The medical workup performed revealed an acute T. gondii infection. She became pregnant in June 2018 while she still had adenopathy. The second obstetrical ultrasound, performed at 16 weeks of pregnancy, revealed a fetal death. The research for T. gondii by PCR was positive in the products of conception.
CONCLUSION
Diagnosis of toxoplasmosis should be discussed in case of miscarriage with lymphadenitis. As lymph nodes in T. gondii infection could be responsible for iterative release of parasites and fetal death, symptomatic toxoplasmosis should be treated in women of childbearing age.
背景
我们报告了一例先天性弓形虫病致死病例，其母体感染发生在怀孕前四个月，且不存在任何特定的免疫抑制状态。
病例
D 女士于 2018 年 2 月出现颌下淋巴结炎。进行的医学检查显示急性 T. gondii 感染。她于 2018 年 6 月怀孕，此时仍有淋巴结病。第二次超声检查在怀孕 16 周时显示胎儿死亡。妊娠产物中 PCR 检测 T. gondii 为阳性。
结论
如果流产伴有淋巴结炎，应讨论弓形虫病的诊断。由于 T. gondii 感染的淋巴结可能导致寄生虫反复释放并导致胎儿死亡，因此应在育龄妇女中治疗有症状的弓形虫病。
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