0000000000768316

AUTHOR

Martine Wallon

Séroconversion toxoplasmique chez la femme enceinte

Resume Introduction La France possede depuis 1992 un programme de prevention de la toxoplasmose reposant sur la detection serologique des infections en cours de grossesse. En l’absence de consensus, les seroconversions depistees sont prises en charge de facon variable selon les centres. Objectif Decrire les pratiques des centres experts francais et faire des propositions pour reduire leur heterogeneite. Methode Enquete postale par questionnaire aupres des centres de parasitologie francais de reference pour la prise en charge des seroconversions toxoplasmiques en cours de grossesse. Resultats La totalite des 30 centres interroges ont repondu. Cinq d’entre eux ne font pas de recommandations t…

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Fast-Growing Alveolar Echinococcosis Following Lung Transplantation

International audience; Alveolar echinococcosis is a rare but life-threatening infection caused by the parasiteEchinococcus multilocularis. Its natural history is characterized by a slow parasitic growth over several years. Increased incidence and shorter development delay have been reported in immune-compromised patients. We report the reactivation of aborted lesions within 12 months of lung transplantation leading to a fast-growing aggressive hepatic lesion. Timely identification of alveolar echninococcosis allowed prompt albendazole treatment and radical surgery leading to a favorable outcome 42 months after transplantation. However, close clinical, serological and radiological monitorin…

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The cost-effectiveness of neonatal versus prenatal screening for congenital toxoplasmosis

BackgroundCongenital Toxoplasmosis (CT) can have severe consequences. France, Austria, and Slovenia have prenatal screening programs whereas some other countries are considering universal screening to reduce congenital transmission and severity of infection in children. The efficiency of such programs is debated increasingly as seroprevalence among pregnant women and incidence of congenital toxoplasmosis show a steady decrease. In addition, uncertainty remains regarding the effectiveness of pre- and postnatal treatments.MethodTo identify cost-effective strategies, prenatal and neonatal screenings were compared using a decision-analytic model based on French guidelines and current knowledge …

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Ophthalmic Outcomes of Congenital Toxoplasmosis Followed Until Adolescence

BACKGROUND: Congenital toxoplasmosis (CT) can elicit severe damage to several organs, especially the eye, and may be manifested at birth or later. We assessed the long-term ocular prognosis in a cohort of congenitally infected children treated according to a standardized protocol and monitored for up to 22 years. METHODS: This prospective study included confirmed cases of CT, which were identified by obligatory antenatal screening at the Lyon (France) reference center between 1987 and 2008. Data obtained through ocular examinations were recorded on a standardized form and confirmed by an independent external committee. Risk factors for retinochoroiditis were identified by using a multivari…

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Congenital \textittoxoplasma infection: monthly prenatal screening decreases transmission rate and improves clinical outcome at age 3 years

Background. Toxoplasma infection during pregnancy exposes the fetus to risks of congenital infection and sequelae that depend heavily on gestational age (GA) at time of infection. Accurate risk estimates by GA are necessary to counsel parents and improve clinical decisions. Methods. We analyzed data from pregnant women diagnosed with acute Toxoplasma infection in Lyon (France) from 1987 to 2008 and assessed how the risks of congenital toxoplasmosis and of clinical signs at age 3 years vary depending on GA at the time of maternal infection. Results. Among 2048 mother-infant pairs, 93.2% of mothers received prenatal treatment and 513 (24.7%) fetuses were infected. Because of a significant red…

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