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Development of adverse sequelae in children born with subclinical congenital Toxoplasma infection
Insights
Congenital Toxoplasma infection often goes undetected in newborns, leading to serious vision and neurological issues like chorioretinitis and developmental delays in affected children. Early diagnosis and prompt treatment are crucial for better outcomes in congenital toxoplasmosis.
Area of Science:
- Ophthalmology
- Neurology
- Infectious Diseases
Background:
- Congenital Toxoplasma infection is frequently asymptomatic at birth, delaying diagnosis.
- Undiagnosed congenital toxoplasmosis can lead to severe long-term health complications.
Purpose of the Study:
- To evaluate the long-term outcomes of congenital Toxoplasma infection in children.
- To compare outcomes between prospectively diagnosed and symptomatically diagnosed cases.
Main Methods:
- Follow-up evaluations of 24 children with congenital Toxoplasma infection.
- Categorization into Group I (prospective diagnosis) and Group II (delayed diagnosis).
- Assessment of ophthalmologic, neurologic, and intellectual development.
Main Results:
- High incidence of chorioretinitis (85% in Group I, 100% in Group II).
- Significant rates of unilateral and bilateral blindness in both groups.
- Development of severe neurologic sequelae, intellectual disability, and declining IQ scores observed.
Conclusions:
- Congenital Toxoplasma infection poses a significant risk for severe visual and neurological impairment.
- Delayed diagnosis is associated with worse outcomes.
- Treatment may offer some benefit, warranting further investigation.
Abstract:
Most infants born with congenital Toxoplasma infection are asymptomatic in the newborn period, and therefore their infection is not recognized. We performed follow-up evaluations on 24 such children. The mean age of these children at least examination was 8.5 years. In group I (13 children), the diagnosis was made prospectively. In group II (11 children), no symptoms or signs were noted in the newborn period and the diagnosis was made only after the first sign developed. Eighty-five percent of the children in group I and all of the children in group II have developed chorioretinitis. In group I, three children (23%) have unilateral blindness; in group II, three children (27%) and five children (45%) have unilateral and bilateral blindness, respectively. One child (8%) in group I and two children (18%) in group II developed severe, permanent neurologic sequelae after they initially presented with eye disease. Two of the children in each group are now retarded (IQ score range, 36 to 62). Six of the children in group I who were tested sequentially have had lower IQ scores (mean change from 97 to 74) on repeat tests performed an average of 5.5 years later. Less severe neurologic, intellectual, and audiologic deficits were observed in other children in each group. Treatment of some children may have had a beneficial effect on their outcome.