ABSTRACT
Congenital toxoplasmosis is a preventable and treatable disease with predominant neurological and ophthalmologic manifestations. These manifestations and approaches to diagnosis, treatment, and prevention of this infection are considered. Outcomes with and without treatment are emphasized. The following also are discussed: recent advances in understanding the organism; its life cycle, epidemiology, pathogenesis, and pathology; and areas in which improvements in diagnosis, treatment, and prevention are needed.
Subject(s)
Toxoplasmosis, Congenital , Animals , Brain Diseases/diagnosis , Brain Diseases/etiology , Brain Diseases/parasitology , Brain Diseases/therapy , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Parasitic , Toxoplasma/physiology , Toxoplasmosis, Congenital/classification , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/etiology , Toxoplasmosis, Congenital/parasitology , Toxoplasmosis, Congenital/therapyABSTRACT
Twenty-six cases of congenital toxoplasmosis observed in the department of Alpes Maritimes (Chief Town: Nice) between 1984 and 1990 are reported. All affected children were treated by pyrimethamine and sulfonamide as soon as the diagnosis was established. None of them exhibited serious sequellae. In most cases (58%) there were no clinical manifestations in agreement with other reports. Benign manifestations were observed in 10 cases (38%): 4 chorioretinitis; 4 intracranial calcifications: 1 febrile seizure; 7 hyperproteinorachias: 3 isolated and 4 associated with other signs. In 3 cases, secondary lesions appeared during the treatment period. This confirms the need for active therapeutic research in order to decrease the risk of late ocular complication which is the major problem of the disease.
Subject(s)
Toxoplasmosis, Congenital/epidemiology , Child , Child, Preschool , Drug Combinations , Follow-Up Studies , France/epidemiology , Humans , Infant , Pyrimethamine/administration & dosage , Retrospective Studies , Sulfonamides/administration & dosage , Toxoplasmosis, Congenital/classification , Toxoplasmosis, Congenital/drug therapyABSTRACT
It has been suggested that congenital toxoplasmosis could be prevented by antenatal serological screening, followed by treatment or by termination of pregnancy if infection occurs. The only study of the incidence of congenital toxoplasmosis in England, Wales, and Northern Ireland took place more than 10 years ago. To obtain more recent figures laboratory reports of cases occurring from 1975 to 1980 were analysed. A total of 91 cases were reported over the six years. By criteria established to classify these infections only 34 were congenital, 20 were acquired postnatally, and 37 were unclassifiable. The mean annual number of cases of congenital toxoplasmosis was considerably smaller than that found in other recent studies. The condition could be underdiagnosed or rates of placental transmission could be lower in Britain than in other countries. Variation in reporting criteria of the laboratories made the data difficult to interpret. Improved diagnosis of congenital toxoplasmosis would not only clarify the epidemiology but would also help clinicians in management of suspected cases. Further antenatal surveys are necessary to assess the role of screening in the prevention of congenital toxoplasmosis.
