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THERAPY FOR CONGENITAL TOXOPLASMOSIS HAS GOOD RESULTS.

Untreated congenital toxoplasmosis usually leaves babies with profound developmental, neurologic, and visual impairment. Treatment regimens have varied, but this major study shows good outcomes in the majority of babies treated with pyrimethamine and sulfadiazine. Physicians treated 36 babies with symptomatic congenital toxoplasmosis with the two drugs for about one year, and followed them for up to 10 years. Within months of treatment initiation, all signs of active toxoplasmosis resolved (e.g., seizures, CSF abnormalities, and chorioretinitis). Abnormalities on cranial imaging resolved or diminished in 15 of 21 infants. Sixteen of the 36 children had normal neurologic exams on every follow-up visit. IQ scores were normal in two thirds of the children, but were significantly lower than those of uninfected siblings. The most frequent residual finding was visual impairment (found in 58 percent). Infants without hydrocephalus had a good prognosis, as did infants with late-developing, shunt-responsive hydrocephalus, whereas 8 of the 10 babies born with hydrocephalus had severe disabilities. Comment: Because of the relatively small sample and young mean age at follow-up (just over 4 years), these results are preliminary. Still, it is remarkable that two thirds of the children, who would have been expected to be severely retarded, had normal intelligence. The authors urge systematic detection and treatment of toxoplasma infection in pregnant women and their infants.

— RA Dershewitz

Published in Journal Watch General Medicine January 17, 1995

Citation(s):

Roizen N, et al. Neurologic and developmental outcome in treated congenital toxoplasmosis. Pediatrics 1995 Jan 95 11-20.

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