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Br J Ophthalmol 1998;82:1444 doi:10.1136/bjo.82.12.1444
  • Letter to the Editor

Congenital toxoplasma chorioretinitis transmitted by preconceptionally immune women

  1. HÉLÈNE DOLLFUS,
  2. PASCAL DUREAU
  1. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  2. Service de Microbiologie, Hôpital Necker-Enfants Malades, Univeristé Paris V, Paris, France
  3. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  4. Service d’Ophtalmologie, Hôpital Général de Dijon, Dijon, France
  5. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  • Accepted 3 June 1998
  1. CHRISTOPHE HENNEQUIN
  1. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  2. Service de Microbiologie, Hôpital Necker-Enfants Malades, Univeristé Paris V, Paris, France
  3. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  4. Service d’Ophtalmologie, Hôpital Général de Dijon, Dijon, France
  5. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  • Accepted 3 June 1998
  1. YVES UTEZA
  1. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  2. Service de Microbiologie, Hôpital Necker-Enfants Malades, Univeristé Paris V, Paris, France
  3. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  4. Service d’Ophtalmologie, Hôpital Général de Dijon, Dijon, France
  5. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  • Accepted 3 June 1998
  1. ALAIN BRON
  1. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  2. Service de Microbiologie, Hôpital Necker-Enfants Malades, Univeristé Paris V, Paris, France
  3. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  4. Service d’Ophtalmologie, Hôpital Général de Dijon, Dijon, France
  5. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  • Accepted 3 June 1998
  1. JEAN LOUIS DUFIER
  1. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  2. Service de Microbiologie, Hôpital Necker-Enfants Malades, Univeristé Paris V, Paris, France
  3. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  4. Service d’Ophtalmologie, Hôpital Général de Dijon, Dijon, France
  5. Service d’Ophtalmologie, Hôpital Necker-Enfants Malades, Université Paris V, Paris, France
  1. Dr Hélène Dollfus, 8 Avenue des Vosges, 67140 Barr, France.
  • Accepted 3 June 1998

Editor,—During pregnancy primary toxoplasmic infection of the mother is a well known cause of congenital chorioretinitis due to fetal contamination by Toxoplasma gondii. It is generally thought that women infected before conception have no risk of transmitting the disease to the fetus unless they are severely immunocompromised.1 We report two children with severe ocular lesions due to congenital toxoplasmosis transmitted by preconceptionally immune mothers.

CASE 1

A 1 year old girl presented with a convergent squint as a consequence of bilateral large macular scars. She was the first child of a healthy immunocompetent mother. Three months before conception, the systematic French prenuptial serological screening of the mother showed a recent toxoplasmic infection diagnosed by a high titre of specific immunoglobulin M (IgM) (IgM 5200, Biotrol Merck (normal <200), IgG= 40 IU/ml) (Table 1). She was treated with spiramycin 3 MIU per day for a month. At the time of referral, the mother’s titre of IgM had significantly decreased (IgM 200) and showed a slightly higher rate of IgG (140 IU/ml). Her daughter’s serological status showed a high titre of specific IgG (624 IU/ml), the presence …

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