Med. Bull. Fukuoka Univ.39 3/4257 261 2012 A Case of a Neonate with Severe Congenital Toxoplasmosis Takashi SETOUE 1, 2 Eiji OHTA 1, 2 Terufumi GOUSHI 3 1, 2 Shinichi HIROSE 1 Division of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital 2 Department of Pediatrics, Faculty of Medicine, Fukuoka University 3 Nakatsu Municipal Hospital Abstract A 3,372-gram male neonate was delivered transvaginally at 38 weeks and 5days of gestation. He was referred to our hospital for further examination 7 days after birth because a lateral ventricular dilatation was detected on ultrasonography at 33 weeks gestation. A Toxoplasma gondii-specific IgM antibody was positive in his peripheral blood. Computed tomography showed hydrocephalus with intracranial calcification. Our diagnosis was congenital toxoplasmosis. Oral administration of pyrimethamine, sulfadoxine, and folic acid started when the patient was 16 days old. Ventriculo-peritoneal shunting was performed at 27 days of age and the boy was 42 days of age with no complications. This treatment continued until he was 1 year old. At that age he was also diagnosed with chorioretinal atrophy. Except for this, his physical and mental development are now at age 3 normal. Key words Toxoplasma gondii, TORCH syndrome, Inapparent infection, Screening, Pyrimethaminesulfadoxine 1 1, 2 1, 2 3, 1, 2 7 33 38 5 3372g 7 IgM CT 16 / 27 VP 42 1 1 3 Toxoplasma gondii TORCH 814-0180 7 45-1 Tel : 092-801-1011 E-mail : t.setoue@minf.med.fukuoka-u.ac.jp
258 Toxoplasma gondii 1985 1 1 10 2 12 80 100 2 3, 4 7 3 23 9 20 33 5 38 5 Apgar score 8 1 / 9 5 3372g 35.5cm +1.6SD 7 CT IgM 13 51.5cm 3560g 37.0cm +2.6SD 37.2 3.0 3.0cm 1.5cm ELISA IgM IgG 10 CT 2 MRI 1 high intensity lesion 3
259.. 10 MRI 3 high intensity lesion 16 25mg 500mg 2 0.3 / 0.15 / 10mg/day 3 / 20 CT VP 21 27 VP 41 39.5cm, 4.49kg 42 1 3 IgM 5 IgG 1 4 5 6 7 11 3 2 11 1 1 2. VP shunt tube
260 CT 1 3 Toxoplasma gondii 10 80 5 1985 1 10 2 0 1 5 80 90 6 Desmonts 7 PCR Polymerase chain reaction 30 2 IgM IgG ELISA 1 IgG 3, 4 Montoya 8 2010 1 2 1 VP 1 3 9 10 6 0.6 44 3.1 110 6,600 0.6 2,900 44 205 6,600 3.1 11 3, 4 12 C
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