Title of Case:

The sequelae of congenital toxoplasmosis – How frequent? How severe?

Background:

Congenital toxoplasmosis (CT) is the main preventable congenital infection in Brazil, however, it can lead to severe sequelae. This manuscript aims to quantify and describe sequelae of CT .

Case Presentation Summary:

Methods: This is a case series study, with data collected from medical records, from infants admitted under one year of age at the Infectious Diseases Clinic of Instituto de Puericultura e Pediatria Martagão Gesteira, reference center from Rio de Janeiro, exposed to toxoplasmosis during their antenatal period. Patients diagnosed with CT were studied and described. The children were followed up for at least one year (during this year they receive sulfadiazine, pyrimathamine, and folinic acid), afterwards the sequelae were evaluated through CNS image exam and ophthalmology evaluation.

Results: A total of 289 patients were followed up in 10 years. CT was confirmed in 43 (14.9%) of which 37 (86%) presented sequelae at the end of follow up. 33 patients presented scars at fundoscopy (19 on macular area) and 24 with Central nervous system (CNS) manifestations (9 hydrocephalus, 18 CNS calcifications, 6 epilepsy, 8 microcephaly), and one child died during the follow up.

Learning Points/Discussion:

Among the children with CT, the sequelae are common and severe. Most of the children with CT developed sequelae even after one year of treatment. Interventions to prevent the CT must be pursued.