Case report of a neonate with ocular toxoplasmosis due to congenital infection: estimation of the percentage of ocular toxoplasmosis in Greece caused by congenital or acquired infection

Asproudis, Ioannis; Koumpoulis, Ioannis; Kalogeropoulos, Chris; Sotiropoulos, Georgios C.; Papassava, Margarita; Aspiotis, Miltiadis

doi:10.2147/opth.s51740

Cited by 5 publications

(7 citation statements)

References 27 publications

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“…Important to note, the newborns with vertical T. gondii transmission usually have a normal appearance and thus congenital toxoplasmosis is not diagnosed and treated in the first years of life. They later, however, may develop chorioretinitis or neurologic and developmental deficits [ 9 ]. Furthermore, in patients with profound T-cell immunodeficiency toxoplasmosis may manifest as potentially fatal encephalitis, pneumonitis, myocarditis and eye diseases, mostly retinochoroiditis [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

1,3,4-Thiadiazoles Effectively Inhibit Proliferation of Toxoplasma gondii

Węglińska

Bekier

Dzitko

et al. 2021

Cells

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Congenital and acquired toxoplasmosis caused by the food- and water-born parasite Toxoplasma gondii (T. gondii) is one of the most prevalent zoonotic infection of global importance. T. gondii is an obligate intracellular parasite with limited capacity for extracellular survival, thus a successful, efficient and robust host cell invasion process is crucial for its survival, proliferation and transmission. In this study, we screened a series of novel 1,3,4-thiadiazole-2-halophenylamines functionalized at the C5 position with the imidazole ring (1b–12b) for their effects on T. gondii host cell invasion and proliferation. To achieve this goal, these compounds were initially subjected to in vitro assays to assess their cytotoxicity on human fibroblasts and then antiparasitic efficacy. Results showed that all of them compare favorably to control drugs sulfadiazine and trimethoprim in terms of T. gondii growth inhibition (IC50) and selectivity toward the parasite, expressed as selectivity index (SI). Subsequently, the most potent of them with meta-fluoro 2b, meta-chloro 5b, meta-bromo 8b, meta-iodo 11b and para-iodo 12b substitution were tested for their efficacy in inhibition of tachyzoites invasion and subsequent proliferation by direct action on established intracellular infection. All the compounds significantly inhibited the parasite invasion and intracellular proliferation via direct action on both tachyzoites and parasitophorous vacuoles formation. The most effective was para-iodo derivative 12b that caused reduction in the percentage of infected host cells by 44% and number of tachyzoites per vacuole by 93% compared to non-treated host cells. Collectively, these studies indicate that 1,3,4-thiadiazoles 1b–12b, especially 12b with IC50 of 4.70 µg/mL and SI of 20.89, could be considered as early hit compounds for future design and synthesis of anti-Toxoplasma agents that effectively and selectively block the invasion and subsequent proliferation of T. gondii into host cells.

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Section: Introductionmentioning

confidence: 99%

1,3,4-Thiadiazoles Effectively Inhibit Proliferation of Toxoplasma gondii

Węglińska

Bekier

Dzitko

et al. 2021

Cells

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“…Moreover, a better understanding of time-dependent factors is required. Particularly, the methods of studying the rates of recurrence are studied need to be very carefully assessed [ 144 ].…”

Section: Methodsmentioning

confidence: 99%

Ocular toxoplasmosis: a review of the current diagnostic and therapeutic approaches

et al. 2021

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Purpose This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up and therapeutic approach of ocular toxoplasmosis focusing mainly on the postnatally acquired form of the disease. Methods A meticulous literature search was performed in the PubMed database. A supplementary search was made in Google Scholar to complete the collected items. Results Ocular toxoplasmosis is one of the most frequent infectious etiologies of posterior uveitis. It typically presents with retinochoroiditis. Setting an accurate diagnosis depends to a considerable degree on detecting characteristic clinical characteristics. In addition to the evaluation of clinical features, the diagnosis of toxoplasmosis relies at a large degree on serologic testing. The detection of the parasite DNA in the aqueous or vitreous humor can provide evidence for a definitive diagnosis. The current mainstay for the treatment, if necessary, is the use of oral antibiotic with systemic corticosteroids. Recent evidence suggests other therapeutic approaches, such as intravitreal antibiotics can be used. Conclusion Recent developments in the diagnostic and therapeutic approach have contributed to preventing or limiting vision loss of patients suffering from ocular toxoplasmosis. Further studies are required to provide a better understanding of epidemiology, pathogenesis, diagnosis, and treatment with a significant impact on the management of this challenging clinical entity.

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“…1,6,7 With regard to the efficacy of treatment on pathological sequelae, the European Multicentre Study of Congenital Toxoplasmosis (EMSCOT) found a reduction in neurological disease such as intracranial lesions, but no reduction in ocular disease risk if prenatal treatment is performed. 5 There were some ocular sequelae risk factors identified, particularly with regard to risk of developing RC. One study found that prematurity, non-ocular CT lesions present at baseline, and confirmed CT diagnosis in early maternal infection were all risk factors for the development of RC.…”

Section: Vertical Transmissionmentioning

confidence: 99%

“…1 Vertical transmission rates are estimated to be less than 10% in the first trimester with typically much more severe CT manifestations compared with a transmission rate of greater than 60% in the third trimester with typically less severe disease in child. 5 Other factors that seem to increase risk of mother-to-child transmission are acute maternal infection during pregnancy, maternal immunocompromise, increased strain virulence, increased parasitic load, and lack of antepartum treatment. 1 In Europe, where prenatal and neonatal screening is mandatory, several centers have studied the benefits of early diagnosis and treatment of toxoplasmosis infection for the health of the child.…”

Section: Vertical Transmissionmentioning

confidence: 99%

“…[3][4][5][6][7][8]10,15,16 Prenatal and antenatal treatment with various antibacterial agents have not shown any effect on the development of retinal lesions, though it has shown to reduce risk of intracranial lesions. 5,7,16 Incidence and severity of retinal scarring, intracranial calcifications, and developmental delay have been shown to be significantly higher in one US study. 9 The authors noted, however, that the severity of clinical manifestations in this cohort could be skewed given only patients with clinically diagnosed CT or high suspicion of it had serum drawn and sent to their laboratory for analysis.…”

Section: Utility Of Screening Europe Versus the United Statesmentioning

confidence: 99%

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Atypical Bilateral Multifocal Congenital Toxoplasmosis Retinochoroiditis: Case Report With Literature Review

Reed

Agarwal-Sinha

2020

Journal of Investigative Medicine High Impact Case Reports

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Background Toxoplasmosis gondii is ubiquitously present on earth and infection, including congenital infection, is common. Neurological, developmental, and ocular effects can be devastating in the congenital toxoplasmosis population. At present, there is no standard, nation-wide neonatal screening for this disease in the United States. Case Presentation A 17-month-old Caucasian female presented to our institution by way of referral for macular scarring. She was diagnosed with intrauterine growth retardation and born with low birth weight and microcephaly at an outside institution, but no systemic workup was conducted at that time. On ocular examination, she was found to have nystagmus and extensive multifocal chorioretinal pigmented scars involving the macula and peripheral retina in both eyes with fibrous vitreous strands extending between scars in the right eye. Toxoplasmosis immunoglobulin G was found to be highly positive. Magnetic resonance imaging of the brain showed supratentorial intracranial calcifications. Conclusions Our patient presented with severe chorioretinal lesions, microcephaly, and nystagmus with a positive immunoglobulin G toxoplasmosis titer. She did not receive any evaluation, including TORCH infectious panel workup, on being born with low birth weight and microcephaly. There are currently no national programs in place for toxoplasmosis to be included in routine neonatal screening, despite the grave sequelae of congenital infection or that studies in other countries have shown cost-effectiveness in early screening and treatment.

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Case report of a neonate with ocular toxoplasmosis due to congenital infection: estimation of the percentage of ocular toxoplasmosis in Greece caused by congenital or acquired infection

Cited by 5 publications

References 27 publications

1,3,4-Thiadiazoles Effectively Inhibit Proliferation of Toxoplasma gondii

1,3,4-Thiadiazoles Effectively Inhibit Proliferation of Toxoplasma gondii

Ocular toxoplasmosis: a review of the current diagnostic and therapeutic approaches

Atypical Bilateral Multifocal Congenital Toxoplasmosis Retinochoroiditis: Case Report With Literature Review

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