[Treatment of subclinical congenital toxoplasmosis by sulfadiazine and pyrimethamine continuously during 1 year: apropos of 46 cases].
In France, most of children suffering from congenital toxoplasmosis have an infraclinic or moderate type at birth. This study aimed at evaluating, on the mid term, tolerance and results of postnatal treatment previously given in severe toxoplasmosis.


METHODS
A retrospective study considered 46 children with a mild or moderate congenital toxoplasmosis treated over 12 months with sulfadiazine-pyrimethamine and treatment was completed since three months.


RESULTS
Five children suffered from a lesion of chorioretinitis during treatment and two after. After a mean follow-up of 27.1 months, ten children (21.7% 95%CI [12.1-35.9]) had at least one ocular injury. Specific IgG titers and immune load were diminished to become almost non-existent at the end of the year of treatment (respectively p < 10(-5) and p = 0.0005). No thrombocytopenia was observed. Twenty-three children (50%) had at least one episode of neutropenia < 1000/mm3, 14 had only one, nine presented two or more installment. None was followed by an infection.


CONCLUSIONS
This therapeutic pathway is more demanding but shorter than those usually offered when associating pyrimethamine-sulfadiazine. Yet, it does give identical result on the mid term. Longer follow-up is needed to appreciate. Active molecule on cysts should be introduced.
Kieffer
F
F
Service de néonatologie, Institut de puériculture de Paris, 26, boulevard Brune 75014 Paris, France. ipp.kieffer@free.fr
Thulliez
P
P
Brézin
A
A
Nobre
R
R
Romand
S
S
Yi-Gallimard
E
E
Voyer
M
M
Magny
J F
JF
D000367:Age Factors; D000704:Analysis of Variance; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011739:Pyrimethamine / Q000008:administration & dosage*; D012189:Retrospective Studies; D013411:Sulfadiazine / Q000008:administration & dosage*; D013997:Time Factors; D014125:Toxoplasmosis, Congenital / Q000188:drug therapy* / Q000276:immunology
D000981:Antiprotozoal Agents; D007074:Immunoglobulin G; D013411:Sulfadiazine; D011739:Pyrimethamine