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Congenital and acquired toxoplasmosis must be addressed, surgeons said
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CANCUN, Mexico — Toxoplasmosis — both congenital and acquired — represents a problem affecting some Latin American countries that must be addressed by ophthalmologists, according to two physicians speaking here.
"We have to be aware of this problem, and we should play a main role" in helping to fix it, said Jacobo Melamed Cattan, MD, at the Pan-American Association of Ophthalmology meeting.
Dr. Cattan discussed congenital toxoplasmosis, which is transmitted during pregnancy and has a varying prevalence, with more than 2,000 cases in countries such as Brazil.
He recommended pregnant women receive blood tests to screen for the disease, which would allow prenatal treatment, although he acknowledged this is not routinely done.
"It is a difficult treatment and has to be done with the obstetrician and the consent of the obstetrician," Dr. Cattan said.
Once a child is born and is at any risk of toxoplasmosis, the role of the ophthalmologist becomes essential because ocular manifestations arise in 70% of cases. Dr. Cattan recommended performing careful eye examinations with the child sedated. He also recommended close follow-up during the first year of life because both active and inactive lesions can affect the child's neurological health.
Rubens Belfort, MD, discussed acquired toxoplasmosis, which represents about 50% of cases.
Although many believe all cases are congenital, cats, meat, water and even air can transmit toxoplasmosis. Also, many patients do not exhibit retinal choroiditis as the first manifestation, he said.
He added that he does believe acquired toxoplasmosis can be prevented by a long course of Bactrim (sulfamethoxazole and trimethoprim).
"The ocular picture takes many years to develop, so it is very important to diagnose early," Dr. Belfort said.