ABSTRACT
The aim of this case report was to present extremely severe, ophthalmic complications in form of rare, congenital toxoplasmatic bilateral defect of eye-balls concomitant with advanced uveitis, microphthalmia and eye-multistructural developmental abnormalities leading to irreversible visual disability. The ocular diagnosis was confirmed in Ret-Cam II and ultrasonography and it was accompanied with congenital multiorgan lesions including hepato-splenomegaly, thrombocytopenia, leukomalacia, hydrocephalus and ventriculomegaly with neurological symptoms. Serology, PCR of cerebro-spinal fluid and cord blood confirmed the presence of congenital Toxoplasma gondii infection in the infant. The authors took the effort of insightful analysis for the causes of applied treatment failure in mother during pregnancy, analyzing the inefficacy of Spiromycin therapy in pregnant woman and evaluating false-negative result of amniocentesis for Toxoplasma gondii presence. Among many issues concerning anti-toxoplasmatic treatment in mother and infant presented in this article, the need for multiple repetition of toxoplasmatic tests should be underlined including amniotic fluid PCR and ultrasonography which can add much important data for correct diagnosis. The authors indicate that the lack of benefits from conservative therapy in case of suspected Toxopalsma gondii suggestion lead to dramatic multiorgan complications, especially ophthalmo-neurologic, leading to irreversible visual disability.
Subject(s)
DNA, Protozoan/isolation & purification , Fetal Diseases/diagnosis , Toxoplasma/isolation & purification , Toxoplasmosis, Congenital/diagnosis , Amniotic Fluid/parasitology , Female , Fetal Diseases/parasitology , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Polymerase Chain Reaction , Pregnancy , Toxoplasmosis, Congenital/parasitologyABSTRACT
Hereby we present a case of a pregnancy in which careful dysmorphology of the fetus in subsequent sonographic evaluation resulted in detection of a very rare anomaly. It allowed explanation of the fetal phenotype, compared then with that of the newborn and estimation of genetic risk for the next pregnancies in this family.
Subject(s)
Abnormalities, Multiple/diagnosis , Abnormalities, Multiple/pathology , Live Birth , Fatal Outcome , Female , Humans , Infant, Newborn , Pregnancy , Rare Diseases , Ultrasonography, PrenatalABSTRACT
PURPOSE: ROP--retinopathy of prematurity is a disease of the retina and the vitreous body of premature infants, especially born before 28 weeks of intrauterine life (71%), rare till 33 weeks of pregnancy (7.6%). The pathogenesis is involved with damage of immature vessels of the retina. The disease seems to self-regress in 80%. According to stage of changes of the retina there could be some complications of the organ of vision like: refractive errors, disturbances of eyeball movement, poor vision or even blindness (19.01%). ROP is now second (after atrophy of the optic nerve) cause of blindness in children (3). Aim of our study was the analysis of the results of laser-treatment in ROP in West Pomeranian region in years 2003-2005 and estimation of the risk factors of advanced stages of ROP. MATERIAL AND METHODS: Since January 2003 to June 2005 in Outpatients Clinic for Premature Infants of the Ophthalmology Department of The West Pomeranian Medical University in Szczecin we have examined 708 children. 40 premature infants (78 eyes) were treated with panphotocoagulation of the retina because of advanced ROP We have used the Ocu-Lights SL laser, manufactured by Iris Medical. RESULTS: Laser treatment caused regression of ROP in 88.5% of children. In 11.5% the progression of ROP caused secondary retina detachment. CONCLUSIONS: Respiratory failure, anemia, infections and multi-organ inflammations increase the risk of ROP Good results of laser treatment depend of beginning of the therapy in the right stage of ROP On the final results of treatment could have got the influence both: immaturity of the child and the showed risk of factors.
