ABSTRACT
En la presente revisión se exponen los diferentes mecanismos de infección parasitaria en el embrión y el feto, que implican generalmente la afectación de la madre y la placenta. Alteraciones de la inmunidad específica e inespecífica del recién nacido pueden justificar, entre otras razones, la aparición de infección parasitaria congénita debida sobre todo a protozoos, como Toxoplasma gondii y plasmodios de la malaria. La clínica, en estos casos, está definida por prematuridad, hepatosplenomegalia, ictericia, anemia y afección del sistema nervioso central, entre otros signos y síntomas. Las secuelas que producen algunos agentes parasitarios se pueden detectar tardíamente, como son las alteraciones oculares, motoras y auditivas, y el retraso mental. El diagnóstico materno precoz y el tratamiento efectivo de la mujer embarazada parasitada pueden hacer disminuir los casos de transmisión congénita de parásitos (AU)
Subject(s)
Female , Male , Humans , Infant, Newborn , Pregnancy Complications, Parasitic/epidemiology , Parasitic Diseases/congenital , Eukaryota/pathogenicity , Protozoan Infections/congenital , Helminths/pathogenicity , Helminthiasis/congenital , Toxoplasmosis/congenital , Trypanosomiasis/congenital , Malaria/congenital , Leishmaniasis/congenital , Pneumocystis Infections/congenitalABSTRACT
This review article presents the epidemiology, pathogenesis, clinical presentation, laboratory and radiologic findings, and treatment of parasitic infections of the central nervous system in children. Some obscure parasitic infections are included. To assist the clinician faced with a specific case, infections are categorized first by predominant clinical manifestations: congenital disease, meningoencephalitis, focal lesions, and disseminated multisystem disease. Within the clinical categories, parasites are grouped according to the geographic area where most human infections occur. Congenital infections and those that present most frequently as meningoencephalitis are discussed in this part of the review.
Subject(s)
Meningoencephalitis/diagnosis , Parasitic Diseases/congenital , Parasitic Diseases/diagnosis , Acanthamoeba/isolation & purification , Angiostrongylus cantonensis/isolation & purification , Animals , Antiprotozoal Agents/therapeutic use , Brain/parasitology , Brain/pathology , Humans , Infant , Infant, Newborn , Magnetic Resonance Imaging , Malaria/drug therapy , Malaria/parasitology , Meningoencephalitis/drug therapy , Meningoencephalitis/parasitology , Naegleria fowleri/isolation & purification , Parasitic Diseases/drug therapy , Plasmodium/isolation & purification , Toxoplasma/isolation & purification , Toxoplasmosis, Congenital/drug therapy , Toxoplasmosis, Congenital/parasitology , Trypanosoma cruzi/isolation & purificationABSTRACT
An analysis of fitness costs and benefits associated with pathogenicity suggests that modes of transmission are key determinants of evolution toward severely pathogenic, benign, or mutualistic symbioses. Specifically, this approach suggests that symbionts with mobile life history stages should evolve toward extremely severe parasitism, vector-borne symbionts should evolve toward severe parasitism in vertebrate hosts and benign parasitism in the vectors, waterborne symbionts should evolve toward severe parasitism, symbionts transmitted by predation should evolve toward severe parasitism in prey hosts and benign parasitism in predator hosts, and vertically transmitted symbionts should evolve toward benign parasitism and mutualism. Detailed reviews of the literature on human diseases support the hypothesized severity of vector-borne and waterborne transmission. Evaluation of the other associations is less detailed, but each association appears to be present. This framework draws attention to the need for detailed reviews of relationships between transmission modes and the nature of symbiotic interactions, and experimental manipulations of transmission.
Subject(s)
Biological Evolution , Host-Parasite Interactions , Parasites/physiology , Parasitic Diseases/transmission , Animals , Bacterial Infections/congenital , Bacterial Infections/transmission , Disease Reservoirs , Disease Vectors , Humans , Parasites/pathogenicity , Parasitic Diseases/congenital , Symbiosis , WaterSubject(s)
Bacterial Infections/diagnosis , Infant, Newborn, Diseases/diagnosis , Virus Diseases/diagnosis , Female , Humans , Infant, Newborn , Listeriosis/congenital , Malaria/congenital , Meningitis/diagnosis , Parasitic Diseases/congenital , Pregnancy , Sepsis/diagnosis , Syphilis, Congenital/diagnosis , Toxoplasmosis, Congenital/diagnosisSubject(s)
Fetal Diseases/etiology , Maternal-Fetal Exchange , Parasitic Diseases/congenital , Placenta/parasitology , Animals , Antibody Formation , Antigen-Antibody Complex , Autoantibodies , Female , Fetal Diseases/immunology , Helminthiasis/congenital , Humans , Hypersensitivity , Leishmaniasis/congenital , Macrophages/physiology , Malaria/congenital , Parasitic Diseases/immunology , Parasitic Diseases/transmission , Phagocytosis , Placenta/anatomy & histology , Placenta Diseases/etiology , Pregnancy , Pregnancy Complications, Infectious , Toxoplasmosis, Congenital , Trypanosomiasis/congenitalABSTRACT
This review focuses on the parasitic diseases which occur frequently in the tropics and which affect pregnant women. Clinical disease of the mother during pregnancy, vertical transmission of parasites and transplacental passage of soluble parasitic antigens are discussed in relation to their immunopathological significance for the fetus. The incidences of congenital malaria, African trypanosomiasis and Chagas' disease are reviewed, together with vertical transmission of filarial infection, involvement of the female genital tract in schistosomiasis, and fulminant colitis due to Entamoeba histolytica infection during pregnancy.
