EARLY TREATMENT FOR CONGENITAL TOXOPLASMA GONDII INFECTION SAVES NEONATES

Potential Vertical Transmission results in serious kind of infection in pregnancy than in non-pregnant stage. Infection can directly pass through Mother to foetus in many ways. Most of the infants with Congenital Toxoplasma gondii infection have no symptoms at birth, but many will have retinal disease or neurologic abnormalities later in life. Early detection and treatment of congenital toxoplasmosis may reduce these sequelae. For this, new-borns have been screened for intrauterine infection with T.gondii by means of an IgM capture immunoassay of blood specimens routinely collected for screening for metabolic disorders. Congenital infection is confirmed by assays for specific IgG and IgM antibodies in serum from infants and their mothers.

To undergo some evaluations, Infants with serologic evidence of infection are made to have extensive clinical evaluation and received one year of treatment. Through that 1000 of 635,000 infants tested had positive screening tests. Congenital infection was confirmed in 520 infants, 500 of whom were identified only through neonatal screening and not through initial clinical examination. However, after the serologic results became available, more detailed examinations revealed abnormalities of either the central nervous system or the retina in 19 of 48 infants evaluated (40 percent). After treatment, only 1 of 46 children had a neurologic deficit (hemiplegia attributable to a cerebral lesion present at birth). Thirty-nine treated children had follow-up ophthalmologic examinations when one to six years old; four (10 percent) had eye lesions that may have developed postnatally (a macular lesion in one child and minor retinal scars in three).

Congenital toxoplasmosis, a protozoan infection that can result in blindness and mental retardation. Most infected new-borns have no symptoms at birth, but serious clinical manifestations can develop during childhood and early adulthood. By the age of 20, up to 85 percent have had chorioretinitis, including many who were free of symptoms at birth. Because congenital toxoplasma infection does not usually produce recognizable signs of infection at birth, we were concerned by the fact that most cases remain untreated because they are not detected by routine clinical examination.

Therefore, serologic screening is the best way to identify infants who should receive therapy, adding a toxoplasma-specific IgM assay to the battery of screening tests carried out on the universally collected new-born “filter-paper” specimens. We report the results of our serologic screening for congenital toxoplasma infection, the spectrum of initial clinical and laboratory findings in infected new-borns, and the clinical outcome of empirical treatment with antitoxoplasma chemotherapy.