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[Unrecognized intrauterine toxoplasmosis despite screening]
A female small for date infant (BW 1500 g) was delivered after uncomplicated pregnancy in the 36th week of gestation. On routine screening for toxoplasmosis a negative SFT had been obtained in the 13th week of gestation. The second examination in the 32nd week was positive (SFT 1:16384). The mother was then put on specific chemotherapy (sulfametoxydiazine and pyrimethamine). The infant, however, had severe- and characteristic lesions (cerebral calcifications, chorioretinitis) not responding to therapy. Morphology of the lesions and serology led to the conclusion that the infant was infected between the 17th and the 24th week of gestation and that the disease remained undetected until the 32nd week, when treatment came already too late. This indicates that in case of a negative test further serological examinations should be carried out at closer intervals to establish the diagnosis in due time.
A female small for date infant (BW 1500 g) was delivered after uncomplicated pregnancy in the 36th week of gestation. On routine screening for toxoplasmosis a negative SFT had been obtained in the 13th week of gestation. The second examination in the 32nd week was positive (SFT 1:16384). The mother was then put on specific chemotherapy (sulfametoxydiazine and pyrimethamine). The infant, however, had severe- and characteristic lesions (cerebral calcifications, chorioretinitis) not responding to therapy. Morphology of the lesions and serology led to the conclusion that the infant was infected between the 17th and the 24th week of gestation and that the disease remained undetected until the 32nd week, when treatment came already too late. This indicates that in case of a negative test further serological examinations should be carried out at closer intervals to establish the diagnosis in due time.