Postnatal ocular toxoplasmosis in immunocompetent patients

  • Olivera Lijeskić National Reference Laboratory for Toxoplasmosis, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
  • Tijana Štajner National Reference Laboratory for Toxoplasmosis, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
  • Jelena Srbljanović National Reference Laboratory for Toxoplasmosis, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
  • Aleksandra Radosavljević Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
  • Branko Bobić National Reference Laboratory for Toxoplasmosis, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
  • Ivana Klun National Reference Laboratory for Toxoplasmosis, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
  • Anka Stanojević-Paović Retina and Uvea Centre, Belgrade, Serbia
  • Olgica Djurković-Djaković National Reference Laboratory for Toxoplasmosis, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
Keywords: Toxoplasma gondii, ocular toxoplasmosis, postnatal infection, immunocompetent patients, strain genotype

Abstract

Introduction: Ocular toxoplasmosis is the most common cause of infectious posterior uveitis worldwide. It can be prenatal or postnatal in origin. Despite estimations that postnatal ocular toxoplasmosis is more prevalent, only several cases of proven postnatal ocular toxoplasmosis have been reported in non-epidemic settings. Here, the clinical evolution of ocular toxoplasmosis of conclusively proven postnatal origin in immunocompetent patients is reported.

Methodology: Postnatal ocular toxoplasmosis was diagnosed based on clinical diagnosis supported by the longitudinal detection of Toxoplasma gondii-specific IgG, IgM and IgA antibodies in the serum as well as by direct detection of the parasite (bioassay) and/or its DNA (real-time PCR) in aqueous humor.

Results: Three cases involved adults in whom ocular toxoplasmosis developed during primary T. gondii infection, as part of the clinical presentation in two and as the sole manifestation in one patient. The fourth patient was a case of inactive ocular toxoplasmosis in a 14-year-old boy, where postnatal infection was confirmed by exclusion of maternal infection. The causative parasite strain was genotyped in only one case and it belonged to genotype II, the dominant type in Europe. One patient acquired the infection in Africa, suggesting an atypical strain.

Conclusions: The distinction between prenatal and postnatal ocular toxoplasmosis is only possible in particular clinical situations, and requires extensive laboratory investigation. Genotyping of the parasite strain involved may be important, particularly if atypical strains are suspected, requiring tailored treatment approaches.

Author Biography

Olgica Djurković-Djaković, National Reference Laboratory for Toxoplasmosis, Institute for Medical Research, University of Belgrade, Belgrade, Serbia

Professor of Research

National Reference Laboratory for Toxoplasmosis

Serbian Centre for Parasitic Zoonoses

Centre of Excellence in Biomedicine

Institute for Medical Research, University of Belgrade

Dr. Subotica 4 P.O.Box 102

11129 Belgrade, Serbia

Published
2021-10-31
How to Cite
1.
Lijeskić O, Štajner T, Srbljanović J, Radosavljević A, Bobić B, Klun I, Stanojević-Paović A, Djurković-Djaković O (2021) Postnatal ocular toxoplasmosis in immunocompetent patients. J Infect Dev Ctries 15:1515-1522. doi: 10.3855/jidc.14824
Section
Original Articles