Report of two cases of toxoplasmosis in pregnant women from the Northwest of Parana State, Brazil <b>[Abstract in English]</b>

Abstract

AIMS: To highlight the difficulty of the various services that comprise the public health system from the Northwest of Paraná in the monitoring of pregnant women with suspected toxoplasmosis, as observed in the present reports, one of a case of congenital toxoplasmosis and the other of severe ocular reagudization. CASES DESCRIPTION: In the first case, the pregnant women had positive serum Toxoplasma gondii-specific IgM, IgG and IgA, and PCR and inoculation in mice positive for Toxoplasma gondii in amniotic fluid. The fetus had ultrasound findings of placentomegalia and cerebral calcifications, and the newborn presented the Sabin tetrad. In the other case, an immunocompetent pregnant woman, with positive Toxoplasma gondii-specific IgG and negative IgM from serum, presented with severe ocular reagudization. Both patients sought the health service in the first trimester of pregnancy, but the referrals occurred between 20 and 32 weeks of gestation. CONCLUSIONS: The lack of agility and knowledge between the various levels of assistance in the control of gestational toxoplasmosis delayed a decision on the part of health professionals. The occurrence of toxoplasmosis in these pregnant women highlights the importance of vertical integration and of implementing strategies that can provide the development of a network of control and adequate management.