Early and longitudinal evaluations of treated infants and children and untreatedhistorical patients with congenital toxoplasmosis: The chicago collaborative treatment trial

James Mc Auley, Kenneth M. Boyer, Dushyant Patel, Marilyn Mets, Charles Swisher, Nancy Roizen, Cheryl Wolters, Laszlo Stein, Mark Stein, William Schey, Jack Remington, Paul Meier, Daniel Johnson, Peter Heydeman, Ellen Holfels, Shawn Withers, Douglas Mack, Charles Brown, Diane Patton, Rima Mc Leod*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

268 Scopus citations

Abstract

Between December 1981 and May 1991, 44 infants and children with congenital toxoplasmosis were referred to our study group. A uniform approach to evaluation and therapy was developed and is described herein along with the clinical characteristics of these infants and children. In addition, case histories that illustrate especially important clinical features or previously undescribed findings are presented. Factors that contributed to the more severe disabilities included delayed diagnosis and initiation of therapy; prolonged, concomitant neonatal hypoxia and hypoglycemia; profound visual impairment; and prolonged, uncorrected increased intracranial pressure with hydrocephalus and compression of the brain. Years after therapy was discontinued, three children developed new retinal lesions (without loss of visual acuity when therapy for Toxoplasma gondii was initiated promptly), and three children experienced a new onset of afebrile seizures. Most remarkable were the normal developmental, neurological, and ophthalmologic findings at the early follow-up evaluations of many-but not all-of the treated children despite severe manifestations, such as substantial systemic disease, hydrocephalus, microcephalus, multiple intracranial calcifications, and extensive macular destruction detected at birth. These favorable outcomes contrast markedly with outcomes reported previously for children with congenital toxoplasmosis who were untreated or treated for only 1 month.

Original languageEnglish (US)
Pages (from-to)38-72
Number of pages35
JournalClinical Infectious Diseases
Volume18
Issue number1
DOIs
StatePublished - Jan 1994

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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