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Published on: November 3, 2009
[Clinical course of congenital toxoplasmosis in children]
H Jankowska1, M Szczepańska-Putz
1Kliniki Chorób Zakaźnych i Pasozytniczych Wieku Dzieciecego AM, Warszawie.
Insights
Congenital toxoplasmosis treatment in children shows that early diagnosis and intervention are crucial. While treatments exist, severe outcomes like psychomotor retardation can still occur, especially in multi-symptomatic cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Parasitology
Background:
- Congenital toxoplasmosis is a significant concern in pediatric infectious diseases.
- Early diagnosis and treatment are critical for managing congenital toxoplasmosis.
- The study reviews a decade of congenital toxoplasmosis cases in children.
Purpose of the Study:
- To analyze the clinical presentation, diagnosis, and treatment outcomes of congenital toxoplasmosis in children.
- To evaluate the effectiveness of different treatment regimens.
- To identify factors influencing prognosis in congenital toxoplasmosis.
Main Methods:
- Retrospective analysis of 111 children diagnosed with congenital toxoplasmosis between 1979 and 1988.
- Categorization of cases based on clinical presentation: multi-symptomatic, ocular, oligosymptomatic, and asymptomatic.
- Review of treatment protocols, including drug choices (pyrimethamine, sulphonamides, spiramycin), dosages, and duration.
Main Results:
- The majority of symptomatic cases (63/111) presented within the first year of life, with diagnosis in 50% (33/111) at this age.
- Ocular form was the most common presentation (65 cases).
- Two of 35 multi-symptomatic cases died; 13 experienced significant psychomotor retardation despite early treatment.
Conclusions:
- Early diagnosis and treatment of congenital toxoplasmosis are vital, particularly for oligosymptomatic and asymptomatic forms.
- Antibody titers do not correlate with infection severity or prognosis.
- Despite treatment, significant long-term neurological sequelae, such as psychomotor retardation, can occur in severe cases.
Abstract:
Hundred eleven children with the congenital toxoplasmosis were treated at the Department of Infectious and Parasitic Diseases in Childhood in 1979-1988. Multi-symptomatic toxoplasmosis has been diagnosed in 35 cases, ocular form in 65, oligosymptomatic in 6, and asymptomatic in 5 cases. Clinical symptoms suggesting congenital toxoplasmosis was seen in the majority of children (63 cases) in the first year of life and the disease was diagnosed in 50% of cases (33 children) at this age. Congenital toxoplasmosis in the group of 78 children has been diagnosed later. The majority of cases was ocular form. Diagnosis of the oligo- and asymptomatic congenital toxoplasmosis is possible in the first year of life, only. A titre of antibodies is exclusively an indicator of the immunologic response, not a severity of infection and does not contribute to the prognosis. Antitoxoplasma drugs were administered to 102 children including 33 under the first year of life. Pyrimethamine, sulphonamides, and spiramycin were used in the treatment. Dosage, duration of therapy, and way of administration have been established individually in dependence of patients age and clinical form of the congenital toxoplasmosis. Two out of 35 children with multi-symptomatic congenital toxoplasmosis died whereas 13 demonstrate psychomotor retardation of significant degree despite the fact that 11 of them were treated in the first year of life.
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