Ocular Manifestations of Congenital Toxoplasmosis Detected Prior to Serological Confirmation: A Case Report
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Purpose
To highlight the importance of ophthalmological examination in the early detection of congenital toxoplasmosis as retinal lesions were identified before serological confirmation of the infection in a neonate.
Methods
We present a case of a full-term neonate born on September 21 (Apgar 10). Despite negative maternal serologies during prenatal care, testing during labor revealed positive Toxoplasma gondii IgG and IgM. Initial laboratory tests in the newborn's blood and cerebrospinal fluid (CSF) showed non-reactive Toxo IgG and IgM, but a fundus exam on September 23 identified a small, active retinal lesion in the nasal region of the right eye (OD).Treatment was only initiated following subsequent serological confirmation of Toxoplasma infection on October 14. Fundus exams were performed at regular intervals to monitor the lesions’ progression and after the start of the treatment.
Results
The first fundus exam detected active retinal lesions in the right eye before positive serology was confirmed, demonstrating the utility of ocular assessment in diagnosing congenital toxoplasmosis. 7 days after starting the treatment, fundus exams showed early healing in the right eye and an active lesion in the left eye. By November 4, 2024, the lesions in both eyes had fully healed. Throughout treatment, the patient remained asymptomatic.
Conclusion
This case underscores the critical role of ophthalmological examination in the early diagnosis of congenital toxoplasmosis, particularly when serological tests are initially negative. The early detection of retinal lesions enabled prompt treatment, leading to rapid lesion resolution and preservation of vision in both eyes.
Conflict of interest
No
1
Last name
LEBER
Initials of first name(s)
Mat
Department
Federal University of Santa Maria
City
Rio de Janeiro
Country
Brazil
2
Last name
Reetz
Initials of first name(s)
A
Department
Federal University of Santa Maria
City
Santa Maria
Country
Brazil
3
Last name
Bianchini
Initials of first name(s)
G
Department
Federal University of Santa Maria
City
Santa Maria
Country
Brazil
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