title: Outcome of treatment for congenital toxoplasmosis, 1981-2004: the National Collaborative Chicago-Based, Congenital Toxoplasmosis Study.
abstract: 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.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, Illinois 60637, USA. rmcleod@midway.uchicago.edu
authors.forename: Rima
authors.initials: R
authors.lastname: McLeod
authors.forename: Kenneth
authors.initials: K
authors.lastname: Boyer
authors.forename: Theodore
authors.initials: T
authors.lastname: Karrison
authors.forename: Kristen
authors.initials: K
authors.lastname: Kasza
authors.forename: Charles
authors.initials: C
authors.lastname: Swisher
authors.forename: Nancy
authors.initials: N
authors.lastname: Roizen
authors.forename: Jessica
authors.initials: J
authors.lastname: Jalbrzikowski
authors.forename: Jack
authors.initials: J
authors.lastname: Remington
authors.forename: Peter
authors.initials: P
authors.lastname: Heydemann
authors.forename: A Gwendolyn
authors.initials: AG
authors.lastname: Noble
authors.forename: Marilyn
authors.initials: M
authors.lastname: Mets
authors.forename: Ellen
authors.initials: E
authors.lastname: Holfels
authors.forename: Shawn
authors.initials: S
authors.lastname: Withers
authors.forename: Paul
authors.initials: P
authors.lastname: Latkany
authors.forename: Paul
authors.initials: P
authors.lastname: Meier
mesh_terms: D000981:Antiprotozoal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002641:Chicago; D003071:Cognition; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use; D013411:Sulfadiazine / Q000008:administration & dosage / Q000627:therapeutic use; D014125:Toxoplasmosis, Congenital / Q000188:drug therapy*; D016896:Treatment Outcome; D014481:United States; D014792:Visual Acuity
chemical_list: D000981:Antiprotozoal Agents; D013411:Sulfadiazine; D011739:Pyrimethamine