TY - JOUR
T1 - Outcome of treatment for congenital toxoplasmosis, 1981-2004
T2 - The national collaborative Chicago-based, congenital toxoplasmosis study
AU - McLeod, Rima
AU - Boyer, Kenneth
AU - Karrison, Theodore
AU - Kasza, Kristen
AU - Swisher, Charles
AU - Roizen, Nancy
AU - Jalbrzikowski, Jessica
AU - Remington, Jack
AU - Heydemann, Peter
AU - Noble, A. Gwendolyn
AU - Mets, Marilyn
AU - Holfels, Ellen
AU - Withers, Shawn
AU - Latkany, Paul
AU - Meier, Paul
PY - 2006/5/15
Y1 - 2006/5/15
N2 - Background. Without treatment, congenital toxoplasmosis has recurrent, recrudescent, adverse outcomes. Long-term follow-up of infants with congenital toxoplasmosis treated throughout their first year of life with pyrimethamine and sulfadiazine has not been reported. Methods. Between 1981 and 2004, one hundred twenty infants (current mean age ± standard deviation, 10.5 ± 4.8 years) with congenital toxoplasmosis were treated with 1 of 2 doses of pyrimethamine plus sulfadiazine; therapy was initiated shortly after birth and continued for 12 months. Children who received treatment were evaluated at birth and at predetermined intervals; the focus of the evaluations was on prespecified end points: motor abnormalities, cognitive outcome, vision impairment, formation of new eye lesions, and hearing loss. Results. Treatment of infants without substantial neurologic disease at birth with pyrimethamine and sulfadiazine for 1 year resulted in normal cognitive, neurologic, and auditory outcomes for all patients. Treatment of infants who had moderate or severe neurologic disease (as defined in this article in the Treatments subsection of Methods) at birth resulted in normal neurologic and/or cognitive outcomes for >72% of the patients, and none had sensorineural hearing loss. Ninety-one percent of children without substantial neurologic disease and 64% of those with moderate or severe neurologic disease at birth did not develop new eye lesions. Almost all of these outcomes are markedly better than outcomes reported for children who were untreated or treated for 1 month in earlier decades (P<.01 to P<.001). Sex and severity of disease were comparable in our 2 treatment groups, and no significant differences in efficacy or toxicity were noted between the 2 treatment groups (P>.05). Conclusions. Although not all children did well with treatment, the favorable outcomes we noted indicate the importance of diagnosis and treatment of infants with congenital toxoplasmosis.
AB - Background. Without treatment, congenital toxoplasmosis has recurrent, recrudescent, adverse outcomes. Long-term follow-up of infants with congenital toxoplasmosis treated throughout their first year of life with pyrimethamine and sulfadiazine has not been reported. Methods. Between 1981 and 2004, one hundred twenty infants (current mean age ± standard deviation, 10.5 ± 4.8 years) with congenital toxoplasmosis were treated with 1 of 2 doses of pyrimethamine plus sulfadiazine; therapy was initiated shortly after birth and continued for 12 months. Children who received treatment were evaluated at birth and at predetermined intervals; the focus of the evaluations was on prespecified end points: motor abnormalities, cognitive outcome, vision impairment, formation of new eye lesions, and hearing loss. Results. Treatment of infants without substantial neurologic disease at birth with pyrimethamine and sulfadiazine for 1 year resulted in normal cognitive, neurologic, and auditory outcomes for all patients. Treatment of infants who had moderate or severe neurologic disease (as defined in this article in the Treatments subsection of Methods) at birth resulted in normal neurologic and/or cognitive outcomes for >72% of the patients, and none had sensorineural hearing loss. Ninety-one percent of children without substantial neurologic disease and 64% of those with moderate or severe neurologic disease at birth did not develop new eye lesions. Almost all of these outcomes are markedly better than outcomes reported for children who were untreated or treated for 1 month in earlier decades (P<.01 to P<.001). Sex and severity of disease were comparable in our 2 treatment groups, and no significant differences in efficacy or toxicity were noted between the 2 treatment groups (P>.05). Conclusions. Although not all children did well with treatment, the favorable outcomes we noted indicate the importance of diagnosis and treatment of infants with congenital toxoplasmosis.
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U2 - 10.1086/501360
DO - 10.1086/501360
M3 - Article
C2 - 16619149
AN - SCOPUS:33646462725
SN - 1058-4838
VL - 42
SP - 1383
EP - 1394
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 10
ER -