Reactivation of ocular toxoplasmosis during pregnancy

Abstract

We wished to assess whether ocular toxoplasmosis can be reactivated during pregnancy in immunocompetent females, and whether such reactivation is confined to the eye or whether the fetus is exposed to the risk of vertical transmission. For this purpose, we retrospectively examined 18 females with ocular toxoplasmosis during the course of 35 pregnancies. Of these 18 patients, seven developed recurrences during seven pregnancies. Due to the potential risk of functional damage to the mother and the possibility of vertical disease transmission to the fetus, we suggest following such cases carefully during pregnancy until the dimensions of the problem are more fully appreciated.

Ocular Toxoplasmosis: Recent Aspects of Pathophysiology and Clinical Implications

“…Over time, the viability of tissue cysts decreases and they eventually die, reducing the pool of organisms and risk of reactivation. Other factors that have been considered to influence recurrences are changes in tissue cysts with reduced release of parasites or antigens, trauma, endocrine fluctuations and transient humoral or cellular immunoreactivity [50,51]. However, none of these putative factors could be substantiated.…”

Recurrence characteristics in European patients with ocular toxoplasmosis

“…The risk of a recurrence appears to be higher during the first year of an active episode of retinochoroiditis (cumulative incidence until end of the first year 21%, until end of the second year 27%) 7. Recurrences may be attributable to senescent changes in tissue cysts, with an ensuing release of parasites or antigens, to trauma, to hormonal fluctuations, to transient humoral or cellular immunoreactivity,8 to pregnancy or to cataract surgery 9 10. The development of severe, progressive and atypical lesions may be exacerbated by age, pregnancy and immunosuppression, but specific triggers for reactivation have not been identified 10 – 17…”

Localized toxoplasmosis in a ring-tailed lemur (Lemur catta) causing placentitis, stillbirths, and disseminated fetal infection

“…19 In women, congenital toxoplasmosis usually results from acquired infection in non-immune pregnant patients, 1 but reactivation of latent infections can also occur in both immunocompetent and immunocompromised pregnant women. 1,11 In the lemur dam of the current report, severe localized (myocardial) toxoplasmosis suggests reactivation of latent infection, which may have been facilitated by stress resulting from cage mate aggression, hospitalization, and/or pregnancy.…”