Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.3201/eid2612.200227 http://hdl.handle.net/1843/51452 https://orcid.org/0000-0001-6713-372X https://orcid.org/0000-0002-4969-8812 https://orcid.org/0000-0003-2427-7699 https://orcid.org/0000-0002-6747-2024 |
Resumo: | In 2015, an outbreak of presumed waterborne toxoplasmosis occurred in Gouveia, Brazil. We conducted a 3-year prospective study on a cohort of 52 patients from this outbreak, collected clinical and multimodal imaging findings, and determined risk factors for ocular involvement. At baseline examination, 12 (23%) patients had retinochoroiditis; 4 patients had bilateral and 2 had macular lesions. Multimodal imaging revealed 2 distinct retinochoroiditis patterns: necrotizing focal retinochoroiditis and punctate retinochoroiditis. Older age, worse visual acuity, self-reported recent reduction of visual acuity, and presence of floaters were associated with retinochoroiditis. Among patients, persons >40 years of age had 5 times the risk for ocular involvement. Five patients had recurrences during follow-up, a rate of 22% per person-year. Recurrences were associated with binocular involvement. Two patients had late ocular involvement that occurred >34 months after initial diagnosis. Patients with acquired toxoplasmosis should have long-term ophthalmic follow-up, regardless of initial ocular involvement. |
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2023-03-31T19:43:01Z2023-03-31T19:43:01Z2020-12261229222932https://doi.org/10.3201/eid2612.2002271080-6059http://hdl.handle.net/1843/51452https://orcid.org/0000-0001-6713-372Xhttps://orcid.org/0000-0002-4969-8812https://orcid.org/0000-0003-2427-7699https://orcid.org/0000-0002-6747-2024In 2015, an outbreak of presumed waterborne toxoplasmosis occurred in Gouveia, Brazil. We conducted a 3-year prospective study on a cohort of 52 patients from this outbreak, collected clinical and multimodal imaging findings, and determined risk factors for ocular involvement. At baseline examination, 12 (23%) patients had retinochoroiditis; 4 patients had bilateral and 2 had macular lesions. Multimodal imaging revealed 2 distinct retinochoroiditis patterns: necrotizing focal retinochoroiditis and punctate retinochoroiditis. Older age, worse visual acuity, self-reported recent reduction of visual acuity, and presence of floaters were associated with retinochoroiditis. Among patients, persons >40 years of age had 5 times the risk for ocular involvement. Five patients had recurrences during follow-up, a rate of 22% per person-year. Recurrences were associated with binocular involvement. Two patients had late ocular involvement that occurred >34 months after initial diagnosis. Patients with acquired toxoplasmosis should have long-term ophthalmic follow-up, regardless of initial ocular involvement.Em 2015, um surto de toxoplasmose presumida de veiculação hídrica ocorreu em Gouveia, Brasil. Conduzimos um estudo prospectivo de 3 anos em uma coorte de 52 pacientes desse surto, coletamos achados de imagem clínicos e multimodais e determinamos fatores de risco para envolvimento ocular. No exame inicial, 12 (23%) pacientes apresentavam retinocoroidite; 4 pacientes tinham lesões bilaterais e 2 tinham lesões maculares. A imagem multimodal revelou 2 padrões distintos de retinocoroidite: retinocoroidite focal necrotizante e retinocoroidite puntiforme. Idade avançada, pior acuidade visual, autorrelato de redução recente da acuidade visual e presença de moscas volantes foram associados à retinocoroidite. Entre os pacientes, pessoas >40 anos de idade tiveram 5 vezes mais risco de envolvimento ocular. Cinco pacientes tiveram recorrências durante o acompanhamento, uma taxa de 22% por pessoa-ano. As recorrências foram associadas ao envolvimento binocular. Dois pacientes tiveram envolvimento ocular tardio que ocorreu >34 meses após o diagnóstico inicial. Pacientes com toxoplasmose adquirida devem ter acompanhamento oftalmológico a longo prazo, independentemente do envolvimento ocular inicial.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoOutra AgênciaengUniversidade Federal de Minas GeraisUFMGBrasilHCL - HOSPITAL DAS CLINICASICB - DEPARTAMENTO DE BIOQUÍMICA E IMUNOLOGIAICB - DEPARTAMENTO DE PARASITOLOGIAEmerging Infectious DiseasesToxoplasmoseToxoplasmose ocularCoriorretinopatia de birdshotTraumatismos ocularesToxoplasmosisOcular involvementRetinochoroiditisMacular lesionsBilateral lesionsClinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, BrazilAchados clínicos e multimodais de imagem e fatores de risco para envolvimento ocular em um suposto surto de toxoplasmose de veiculação hídrica, Brasilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://wwwnc.cdc.gov/eid/article/26/12/20-0227_articleCamilo Brandão-de-ResendeHelena Hollanda SantosAngel Alessio Rojas LagosCamila Munayert LaraJacqueline Souza Dutra ArrudaAna Paula Maia Peixoto MarinoLis Ribeiro do Valle AntonelliRicardo Tostes GazzinelliRicardo Wagner de Almeida VitorDaniel Vitor Vasconcelos Santosapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/51452/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALClinical and Multimodal Imaging Findings and Risk Factors for Ocular Involvement in a Presumed Waterborne Toxoplasmosis Outbreak, Brazil.pdfClinical and Multimodal Imaging Findings and Risk Factors for Ocular Involvement in a Presumed Waterborne Toxoplasmosis Outbreak, Brazil.pdfapplication/pdf22035943https://repositorio.ufmg.br/bitstream/1843/51452/2/Clinical%20and%20Multimodal%20Imaging%20Findings%20and%20Risk%20Factors%20for%20Ocular%20Involvement%20in%20a%20Presumed%20Waterborne%20Toxoplasmosis%20Outbreak%2c%20Brazil.pdfd1da59df6d5ff5558beab3c0566363e3MD521843/514522023-03-31 16:43:02.089oai:repositorio.ufmg.br:1843/51452TElDRU7vv71BIERFIERJU1RSSUJVSe+/ve+/vU8gTu+/vU8tRVhDTFVTSVZBIERPIFJFUE9TSVTvv71SSU8gSU5TVElUVUNJT05BTCBEQSBVRk1HCiAKCkNvbSBhIGFwcmVzZW50Ye+/ve+/vW8gZGVzdGEgbGljZW7vv71hLCB2b2Pvv70gKG8gYXV0b3IgKGVzKSBvdSBvIHRpdHVsYXIgZG9zIGRpcmVpdG9zIGRlIGF1dG9yKSBjb25jZWRlIGFvIFJlcG9zaXTvv71yaW8gSW5zdGl0dWNpb25hbCBkYSBVRk1HIChSSS1VRk1HKSBvIGRpcmVpdG8gbu+/vW8gZXhjbHVzaXZvIGUgaXJyZXZvZ++/vXZlbCBkZSByZXByb2R1emlyIGUvb3UgZGlzdHJpYnVpciBhIHN1YSBwdWJsaWNh77+977+9byAoaW5jbHVpbmRvIG8gcmVzdW1vKSBwb3IgdG9kbyBvIG11bmRvIG5vIGZvcm1hdG8gaW1wcmVzc28gZSBlbGV0cu+/vW5pY28gZSBlbSBxdWFscXVlciBtZWlvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3Mg77+9dWRpbyBvdSB277+9ZGVvLgoKVm9j77+9IGRlY2xhcmEgcXVlIGNvbmhlY2UgYSBwb2zvv710aWNhIGRlIGNvcHlyaWdodCBkYSBlZGl0b3JhIGRvIHNldSBkb2N1bWVudG8gZSBxdWUgY29uaGVjZSBlIGFjZWl0YSBhcyBEaXJldHJpemVzIGRvIFJJLVVGTUcuCgpWb2Pvv70gY29uY29yZGEgcXVlIG8gUmVwb3NpdO+/vXJpbyBJbnN0aXR1Y2lvbmFsIGRhIFVGTUcgcG9kZSwgc2VtIGFsdGVyYXIgbyBjb250Ze+/vWRvLCB0cmFuc3BvciBhIHN1YSBwdWJsaWNh77+977+9byBwYXJhIHF1YWxxdWVyIG1laW8gb3UgZm9ybWF0byBwYXJhIGZpbnMgZGUgcHJlc2VydmHvv73vv71vLgoKVm9j77+9IHRhbWLvv71tIGNvbmNvcmRhIHF1ZSBvIFJlcG9zaXTvv71yaW8gSW5zdGl0dWNpb25hbCBkYSBVRk1HIHBvZGUgbWFudGVyIG1haXMgZGUgdW1hIGPvv71waWEgZGUgc3VhIHB1YmxpY2Hvv73vv71vIHBhcmEgZmlucyBkZSBzZWd1cmFu77+9YSwgYmFjay11cCBlIHByZXNlcnZh77+977+9by4KClZvY++/vSBkZWNsYXJhIHF1ZSBhIHN1YSBwdWJsaWNh77+977+9byDvv70gb3JpZ2luYWwgZSBxdWUgdm9j77+9IHRlbSBvIHBvZGVyIGRlIGNvbmNlZGVyIG9zIGRpcmVpdG9zIGNvbnRpZG9zIG5lc3RhIGxpY2Vu77+9YS4gVm9j77+9IHRhbWLvv71tIGRlY2xhcmEgcXVlIG8gZGVw77+9c2l0byBkZSBzdWEgcHVibGljYe+/ve+/vW8gbu+/vW8sIHF1ZSBzZWphIGRlIHNldSBjb25oZWNpbWVudG8sIGluZnJpbmdlIGRpcmVpdG9zIGF1dG9yYWlzIGRlIG5pbmd177+9bS4KCkNhc28gYSBzdWEgcHVibGljYe+/ve+/vW8gY29udGVuaGEgbWF0ZXJpYWwgcXVlIHZvY++/vSBu77+9byBwb3NzdWkgYSB0aXR1bGFyaWRhZGUgZG9zIGRpcmVpdG9zIGF1dG9yYWlzLCB2b2Pvv70gZGVjbGFyYSBxdWUgb2J0ZXZlIGEgcGVybWlzc++/vW8gaXJyZXN0cml0YSBkbyBkZXRlbnRvciBkb3MgZGlyZWl0b3MgYXV0b3JhaXMgcGFyYSBjb25jZWRlciBhbyBSZXBvc2l077+9cmlvIEluc3RpdHVjaW9uYWwgZGEgVUZNRyBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7vv71hLCBlIHF1ZSBlc3NlIG1hdGVyaWFsIGRlIHByb3ByaWVkYWRlIGRlIHRlcmNlaXJvcyBlc3Tvv70gY2xhcmFtZW50ZSBpZGVudGlmaWNhZG8gZSByZWNvbmhlY2lkbyBubyB0ZXh0byBvdSBubyBjb250Ze+/vWRvIGRhIHB1YmxpY2Hvv73vv71vIG9yYSBkZXBvc2l0YWRhLgoKQ0FTTyBBIFBVQkxJQ0Hvv73vv71PIE9SQSBERVBPU0lUQURBIFRFTkhBIFNJRE8gUkVTVUxUQURPIERFIFVNIFBBVFJPQ++/vU5JTyBPVSBBUE9JTyBERSBVTUEgQUfvv71OQ0lBIERFIEZPTUVOVE8gT1UgT1VUUk8gT1JHQU5JU01PLCBWT0Pvv70gREVDTEFSQSBRVUUgUkVTUEVJVE9VIFRPRE9TIEUgUVVBSVNRVUVSIERJUkVJVE9TIERFIFJFVklT77+9TyBDT01PIFRBTULvv71NIEFTIERFTUFJUyBPQlJJR0Hvv73vv71FUyBFWElHSURBUyBQT1IgQ09OVFJBVE8gT1UgQUNPUkRPLgoKTyBSZXBvc2l077+9cmlvIEluc3RpdHVjaW9uYWwgZGEgVUZNRyBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lKHMpIG91IG8ocykgbm9tZXMocykgZG8ocykgZGV0ZW50b3IoZXMpIGRvcyBkaXJlaXRvcyBhdXRvcmFpcyBkYSBwdWJsaWNh77+977+9bywgZSBu77+9byBmYXLvv70gcXVhbHF1ZXIgYWx0ZXJh77+977+9bywgYWzvv71tIGRhcXVlbGFzIGNvbmNlZGlkYXMgcG9yIGVzdGEgbGljZW7vv71hLgo=Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-03-31T19:43:02Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil |
dc.title.alternative.pt_BR.fl_str_mv |
Achados clínicos e multimodais de imagem e fatores de risco para envolvimento ocular em um suposto surto de toxoplasmose de veiculação hídrica, Brasil |
title |
Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil |
spellingShingle |
Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil Camilo Brandão-de-Resende Toxoplasmosis Ocular involvement Retinochoroiditis Macular lesions Bilateral lesions Toxoplasmose Toxoplasmose ocular Coriorretinopatia de birdshot Traumatismos oculares |
title_short |
Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil |
title_full |
Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil |
title_fullStr |
Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil |
title_full_unstemmed |
Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil |
title_sort |
Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil |
author |
Camilo Brandão-de-Resende |
author_facet |
Camilo Brandão-de-Resende Helena Hollanda Santos Angel Alessio Rojas Lagos Camila Munayert Lara Jacqueline Souza Dutra Arruda Ana Paula Maia Peixoto Marino Lis Ribeiro do Valle Antonelli Ricardo Tostes Gazzinelli Ricardo Wagner de Almeida Vitor Daniel Vitor Vasconcelos Santos |
author_role |
author |
author2 |
Helena Hollanda Santos Angel Alessio Rojas Lagos Camila Munayert Lara Jacqueline Souza Dutra Arruda Ana Paula Maia Peixoto Marino Lis Ribeiro do Valle Antonelli Ricardo Tostes Gazzinelli Ricardo Wagner de Almeida Vitor Daniel Vitor Vasconcelos Santos |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Camilo Brandão-de-Resende Helena Hollanda Santos Angel Alessio Rojas Lagos Camila Munayert Lara Jacqueline Souza Dutra Arruda Ana Paula Maia Peixoto Marino Lis Ribeiro do Valle Antonelli Ricardo Tostes Gazzinelli Ricardo Wagner de Almeida Vitor Daniel Vitor Vasconcelos Santos |
dc.subject.por.fl_str_mv |
Toxoplasmosis Ocular involvement Retinochoroiditis Macular lesions Bilateral lesions |
topic |
Toxoplasmosis Ocular involvement Retinochoroiditis Macular lesions Bilateral lesions Toxoplasmose Toxoplasmose ocular Coriorretinopatia de birdshot Traumatismos oculares |
dc.subject.other.pt_BR.fl_str_mv |
Toxoplasmose Toxoplasmose ocular Coriorretinopatia de birdshot Traumatismos oculares |
description |
In 2015, an outbreak of presumed waterborne toxoplasmosis occurred in Gouveia, Brazil. We conducted a 3-year prospective study on a cohort of 52 patients from this outbreak, collected clinical and multimodal imaging findings, and determined risk factors for ocular involvement. At baseline examination, 12 (23%) patients had retinochoroiditis; 4 patients had bilateral and 2 had macular lesions. Multimodal imaging revealed 2 distinct retinochoroiditis patterns: necrotizing focal retinochoroiditis and punctate retinochoroiditis. Older age, worse visual acuity, self-reported recent reduction of visual acuity, and presence of floaters were associated with retinochoroiditis. Among patients, persons >40 years of age had 5 times the risk for ocular involvement. Five patients had recurrences during follow-up, a rate of 22% per person-year. Recurrences were associated with binocular involvement. Two patients had late ocular involvement that occurred >34 months after initial diagnosis. Patients with acquired toxoplasmosis should have long-term ophthalmic follow-up, regardless of initial ocular involvement. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-12 |
dc.date.accessioned.fl_str_mv |
2023-03-31T19:43:01Z |
dc.date.available.fl_str_mv |
2023-03-31T19:43:01Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/51452 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.3201/eid2612.200227 |
dc.identifier.issn.pt_BR.fl_str_mv |
1080-6059 |
dc.identifier.orcid.pt_BR.fl_str_mv |
https://orcid.org/0000-0001-6713-372X https://orcid.org/0000-0002-4969-8812 https://orcid.org/0000-0003-2427-7699 https://orcid.org/0000-0002-6747-2024 |
url |
https://doi.org/10.3201/eid2612.200227 http://hdl.handle.net/1843/51452 https://orcid.org/0000-0001-6713-372X https://orcid.org/0000-0002-4969-8812 https://orcid.org/0000-0003-2427-7699 https://orcid.org/0000-0002-6747-2024 |
identifier_str_mv |
1080-6059 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
Emerging Infectious Diseases |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Universidade Federal de Minas Gerais |
dc.publisher.initials.fl_str_mv |
UFMG |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
HCL - HOSPITAL DAS CLINICAS ICB - DEPARTAMENTO DE BIOQUÍMICA E IMUNOLOGIA ICB - DEPARTAMENTO DE PARASITOLOGIA |
publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais |
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