Approach to ocular toxoplasmosis including pregnant women.

Abstract

PURPOSE OF REVIEW:

To discuss available information on the effectiveness of anti-toxoplasma therapy for ocular toxoplasmosis and to provide clinicians with a practical approach to the disease.

RECENT FINDINGS:

Only eleven randomized studies were identified. In the three studies for acute retinitis, there was a clear trend in favor of treatment. In the two studies for the prevention of recurrences, trimethoprim-sulfamethoxazole prophylaxis was superior to placebo. In the six studies comparing different regimens, there was no statistically significant difference between the regimens. In the setting of acute posterior uveitis suspected to be caused by toxoplasma, serological testing should always be obtained, and anti-toxoplasma drug treatment, and corticosteroids should be instituted for at least 6 weeks. Toxoplasmic chorioretinitis during pregnancy represents a particular challenge.

SUMMARY:

Treatment with at least two drugs and corticosteroids should be offered to patients with active toxoplasmic chorioretinitis. Pregnant women with confirmed acute infection and concomitant acute retinitis should be treated for the ocular lesion(s) and to prevent vertical transmission. Pregnant women with chronic Toxoplasma infection acquired prior to gestation and concomitant retinitis by reactivation should be treated for the retinitis and monitored for vertical transmission.

• Authors: Jorge A Cortés, Álvaro Roncancio, Luis Guillermo Uribe, Carlos Fernando Cortés-Luna, José G Montoya
• Journal: Current opinion in infectious diseases (Curr Opin Infect Dis) Vol. 32 Issue 5 Pg. 426-434 (10 2019) ISSN: 1473-6527 [Electronic] United States
• PMID: 31313714 (Publication Type: Journal Article, Systematic Review)

Chemical References

• Adrenal Cortex Hormones
• Anti-Inflammatory Agents
• Antiprotozoal Agents

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Anti-Inflammatory Agents (therapeutic use)
• Antiprotozoal Agents (therapeutic use)
• Diagnostic Tests, Routine (methods)
• Disease Management
• Female
• Humans
• Middle Aged
• Pregnancy
• Pregnancy Complications, Infectious (diagnosis, drug therapy)
• Pregnant Women
• Randomized Controlled Trials as Topic
• Toxoplasmosis, Ocular (diagnosis, drug therapy)
• Treatment Outcome