Abstract

The clinical findings of neonatal hypopituitarism depend on the causes and on presence and extent of hormonal deficiency. Patients may be asymptomatic or may demonstrate non-specific symptoms, but may still be at risk for development of pituitary hormone deficiency over time. Patient history, physical examination, endocrinological, radiological and genetic evaluations are all important for early diagnosis and treatment. Links: Neonatal Hypopituitarism

Septo-optic Dysplasia-Nature

Ocular findings in Congenital Toxoplasomsis:

• 79% patients have chorioretinal scars *Scar may involve macula with significant decrease in visual acuity
• scar may involve periheral area with decreased acuity by dragging of macula

Normal Retina

Chorioretinal scar in congenital toxoplasmosis

Other posterior ocular complications include:

• retinal attachment and active chorioretinitis in 10%
• Optic atrophy in 20%
• Other findings may include: cataracts, microphtalmia, microcornea, nystagmus.

Classic triad of findings in congenital toxoplasmosis includes:

1. chorioretinitis
2. hydrocephalus, and
3. intracranial calcifications.

See also: Toxoplasmosis- AAPOS

What are the symptoms of newly acquired toxoplasmosis in an adult?

More than 80% of newly infected persons experience no symptoms, and are unlikely to be aware of the infection.

Symptoms may occur following an incubation period of one to two weeks after exposure and include:

*mild fever

*swollen glands

*malaise

*muscle and/or joint pain

*headache

*sore throat, and

*skin rash.

*Eye symptoms may include blurred vision or floaters during active disease.

The diagnosis can be confirmed by detecting antibodies to Toxoplasma in the blood. Swelling of the liver or spleen may be noted, and in rare cases the lungs, brain, liver, or heart may be involved. The condition usually resolves without treatment within a few months.

See also: CDC- Toxoplasmosis

Toxoplasmosis

Source of Infection in humans:

1. Eating under cooked meat of animals harboring tissue cysts
2. Consuming food or water contaminated with cat feces or by contaminated environmental samples (such as fecal-contaminated soil or changing the litter box of a pet cat)
3. Blood transfusion or organ transplantation
4. Transplacentally from mother to fetus

Sources of T. gondi infection

Life cycle of T. gondi

The “other” category now includes:

*Lymphocytic Choriomeningitis virus (LCMV)

*Parvovirus B19

*Enteroviruses,

*Varicella-zoster virus

*Epstein-Barr virus

*Human immunodeficiency virus (HIV)

*West Nile virus, and

• Zika virus (ZIKV).

The most complex events in embryogenesis involving the sensory organs take place during the first few weeks of pregnancy, making the eyes and ears particularly vulnerable. The fetus does not have the immunologic mechanisms needed to eliminate the organism, leading to immunologic tolerance and chronic infection.

The most common eye finding of congenital infections is a chorioretinal scar. Congenital cataracts, optic nerve atrophy, or hypoplasia may also be found.

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