Non-Immune Hydrops Foetalis due to Congenital Toxoplasmosis: a rare case report with review of literature.

  • Mallikarjun Adiveppa Pattanashetti Assistant Professor , Department of Pathology, S.Nijalingappa Medical College , Bagalkot
  • Vijayalaxmi V Suranagi Professor, Department of Pathology, Jawaharlal Nehru Medical College, Belagavi
  • Hema B Bannur Professor, Department of Pathology, Jawaharlal Nehru Medical College, Belagavi
Keywords: Non-Immune Hydrops Foetalis, toxoplasmosis, hypoplastic lungs

Abstract

Non-Immune Hydrops Foetalis (NIHF) implies an excess of total body water which manifests as extracellular accumulation of fluid in serous cavities and soft tissues of foetus without any detectable circulating antibody against RBC antigen. Toxoplasmosis is an important congenitally acquired infectious cause of NIHF.Mother had complaints of fever, reduced foetal movements, USG showed hydrops foetalis and she tested positive for Toxoplasma IgG antibodies. On autopsy, foetus had generalised subcutaneous oedema, bilateral hypoplastic lungs  with pleural effusion and oedema of brain with ventriculomegaly suggestive of  hydrocephalus. We report a rare case of NIHF due to congenital toxoplasmosis with bilateral hypoplastic lungs, with emphasis on epidemiology and prevention of toxoplasmosis. DOI: 10.21276/APALM.1077

References

1) Trainor B, Tubman R. The Emerging Pattern of Hydrops Fetalis - Incidence, aetiology and management. Ulster Med J 2006;75(3):185–6.
2) Nagaraja B, Ramana BV, Murty DS, Naidu K, Reddy Kailasanatha B. Prevalence of Toxoplasmosis among Antenatal Women with Bad Obstetric History. IJPRBS, 2012;1(3):222–7.
3) Torgerson PR, Mastroiacovo P. The global burden of congenital toxoplasmosis: a systematic review. Bull World Health Organ 2013;91:501-8.
4) Norton ME, Chauhan SP, Dashe JS. Society for Maternal-Fetal Medicine(SMFM) Clinical Guideline #7 : Nonimmune hydrops fetalis. Am J Obstet Gynecol 2015.;127-133.
5) Mascaretti RS, Falcão MS , Silva AM, Costa Vaz FA, Leone CR. Characterization of newborns with Nonimmune Hydrops Fetalis admitted to a Neonatal Intensive Care Unit. Rev. Hosp. Clín. Fac. Med. S. Paulo 2003;58(3):125-132.
6) Jones JL, Lopez A,Wilson M, Schulkin J, Gibbs R. Congenital toxoplasmosis: a review. Obstet Gynecol Surv 2001;56(5):296-305.
7) Singh S, Munawwar A, Rao S, Mehta S, Hazarika NK. Serologic Prevalence of Toxoplasma gondii in Indian Women of Child Bearing Age and Effects of Social and Environmental Factors. PLoS Negl Trop Dis 2014;8(3):e2737.
8) Singh S, Singh N. Toxoplasmosis is sexually transmitted. Proceeding of IX International Conference on AIDS. Berlin, Germany. 1993; 6–11.
9) Palanisamy M, Madhavan B, Balasundaram MB, Andavar R, Venkatapathy N. Outbreak of ocular toxoplasmosis in Coimbatore, India. Indian J Ophthalmol 2006;54:129-31.
10) Serranti D, Buonsenso D, Valentini P. Congenital toxoplasmosis treatment. Eur Rev for Med Pharmacol Sci 2011;15:193-8.
11) Mittal V, Ichhpujani RL. Toxoplasmosis – An Update. Trop Parasitol 2011; 1(1):9–14.
12) Dubey JP, Beattie CP. Toxoplasmosis of animals and man. Boca Raton, FL: CRC Press, Chapter 1.General Biology: Section V, Epidemiology and Epizootiology. 1988, pp 24.
13) Giannoulis C, Zournatzi B, Giomisi A, Diza E, Tzafettas I. Toxoplasmosis during pregnancy: a case report and review of the literature. Hippokratia 2008;12(3):139–143.
14) Paquet C, Yudin M.H. Toxoplasmosis in Pregnancy: Prevention, Screening and Treatment. J Obstet Gynaecol Can 2013;35:S1–S7.
15) Iqbal J, Khalid N. Detection of acute Toxoplasma gondii infection in early pregnancy by IgG avidity and PCR analysis. J.Med.Microbiol 2007;(56):1495–9.
Published
2017-03-28
Section
Case Report