Ophthalmological findings in children with congenital toxoplasmosis. Report from a Swedish prospective screening study of congenital toxoplasmosis with two years of follow-up.
Congenital toxoplasmosis may lead to severe visual impairment or neurological sequelae in the child.


OBJECTIVE
To study the severity of the primary and late ophthalmological dysfunction during a prospective incidence study of congenital toxoplasmosis in the Stockholm and Skåne counties.


METHODS
Blood collected on phenylketonuria (PKU) cards from 40,978 consecutively born children were investigated for antitoxoplasma antibodies. Children with verified congenital toxoplasmosis were treated for 12 months with antiparasitic therapy and followed ophthalmologically, neurologically and serologically every third month.


RESULTS
Three children had congenital toxoplasmosis. Two of these were asymptomatic at birth and would have escaped early detection without screening. One child had unilateral severe visual impairment and CNS involvement. The incidence of congenital toxoplasmosis was less than 1:10,000.


CONCLUSIONS
Neonatal screening is of importance to diagnose asymptomatic infected children with congenital toxoplasmosis as treatment has been shown to reduce long-term sequelae. Ophthalmological investigations should start early and continue in co-operation with paediatricians.
Fahnehjelm
K T
KT
Department of Clinical Science, Karolinska Institutet, Huddinge University Hospital, Sweden. kristina.fahnehjelm@klinvet.ki.se
Malm
G
G
Ygge
J
J
Engman
M L
ML
Maly
E
E
Evengård
B
B
D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002825:Chorioretinitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D016054:DNA, Protozoan / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D015994:Incidence; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D013548:Sweden / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014122:Toxoplasma / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D015351:Vision Screening
D000913:Antibodies, Protozoan; D000981:Antiprotozoal Agents; D016054:DNA, Protozoan; D007074:Immunoglobulin G; D007075:Immunoglobulin M