HYDROPS FETALIS SECONDARY TO TOXOPLASMA GONDII AND TREPONEMA PALLIDUM COINFECTION: CASE REPORT AND BRIEF LITERATURE REVIEW: case report and brief literature review

Mulakwa Morisho  Lambert; Munguakonkwa Mwenge   Guillain; Bravo Christian  Ayishabage; Cirimwami Muganda    Serge; Maroyi Rodrigue Ngalo; Gakne Manikase    Serge; Bamavu  Charles   Amisi; Ahadi  Justin  Byamungu; Kirembe  Armand    Kafayo

doi:10.51168/sjhrafrica.v5i9.1354

Authors

Mulakwa Morisho Lambert Biomedical Research Unit, Vaccines and Antimicrobial Resistance; Muhungu-Etat Health Center, Bukavu, South Kivu, DR Congo
Munguakonkwa Mwenge Guillain 7The University of Tokyo Hospital, Translational Research Center, Biodesign Team, Tokyo, R. Japan
Bravo Christian Ayishabage Preventive and Curative Service; Muhungu-Etat Health Center, Bukavu, South Kivu, DR Congo, Prenatal and Maternity Consultation Service, Muhungu-Etat Health Center, Bukavu, South Kivu, DR CongoPrenatal and Maternity Consultation Service, Muhungu-Etat Health Center, Bukavu, South Kivu, DR Congo
Cirimwami Muganda Serge Vaccination Service, French Red Cross Health and Prevention Center in Kourou, Kourou, French Guyana 9Faculty of medicine, ‘’ université libre de bruxelles’’, Brussels, Belgium
Maroyi Rodrigue Ngalo 2Preventive and Curative Service; Muhungu-Etat Health Center, Bukavu, South Kivu, DR Congo , 3Prenatal and Maternity Consultation Service, Muhungu-Etat Health Center, Bukavu, South Kivu, DR Congo
Gakne Manikase Serge Medical Analysis Laboratory Department, Baptiste Mid-Mission Hospital Center, Koumra, R Chad
Bamavu Charles Amisi Coordination of Leprosy and Tuberculosis Control, Maniema Provincial Health Division, Kindu, DR Congo
Ahadi Justin Byamungu Medical Analysis Laboratory Department, Muhungu-Etat Health Center, Bukavu, South Kivu, DR Congo
Kirembe Armand Kafayo Biomedical Research Unit, Vaccines and Antimicrobial Resistance; Muhungu-Etat Health Center, Bukavu, South Kivu, DR Congo

DOI:

https://doi.org/10.51168/sjhrafrica.v5i9.1354

Keywords:

Hydrops Fetalis, Syphilis, Toxoplasmosis, Co-Infection, Delivery

Abstract

Background

Hydrops fetalis is a pathological condition in which fluid accumulates in the fetus in an extracellular environment, leading to subcutaneous edema and possible accumulation in the fetal body and abdominal cavity. The most common causes in this region are infectious, making systematic monitoring during pregnancy essential. However, it is difficult to apply this guideline in urban areas, and even more so in rural areas with few resources for investigation, as in this patient's case, monitoring was ineffective.

The aim was to carry out infection studies in maternal blood samples taken after giving birth to a newborn in hydrops.

Case presentation

A 36-year-old rural woman in her 6th pregnancy presented with uterine contractions in what was thought to be a full-term pregnancy. The progress of this pregnancy had not been monitored throughout the antenatal period for unknown reasons despite a clinical presentation characterized by breathlessness and generalized edema. The obstetric gynecology clinical examination revealed a mattress-like appearance suggestive of placenta previa, and a cesarean section was indicated with the extraction of a newborn with hydrops fetalis who died despite resuscitation efforts. An infectious disease investigation after delivery revealed the presence of both Treponema pallidum and Toxoplasma gondii in the maternal blood sample.

Conclusion

This state of hydrops fetalis was secondary to this co-infection, which is very difficult to manage in such conditions, facilitated by the lack of systematic biological monitoring for pathogens that could harm both the fetus and the mother.

Recommendation

Facilitate prenatal visits to women, especially in rural areas where access to services is limited, through home visits from health workers and community relays.

During the monthly antenatal visit, pregnant women should be subjected to compulsory infectious screening to provide suitable conditions for the fetus.