title: Congenital toxoplasmosis in a reference center of Paraná, Southern Brazil.
abstract: This study describes the characteristics of 31 children with congenital toxoplasmosis children admitted to the University Hospital of Londrina, Southern Brazil, from 2000 to 2010. In total, 23 (85.2%) of the mothers received prenatal care but only four (13.0%) were treated for toxoplasmosis. Birth weight was <2500g in 37.9% of the infants. During the first month of life, physical examination was normal in 34.5%, and for those with clinical signs and symptoms, the main manifestations were hepatomegaly and/or splenomegaly (62.1%), jaundice (13.8%), and microcephaly (6.9%). During ophthalmic examination, 74.2% of the children exhibited injuries, 58.1% chorioretinitis, 32.3% strabismus, 19.4% microphthalmia, and 16.2% vitreitis. Anti-Toxoplasma gondii IgM antibodies were detected in 48.3% of the children. Imaging brain evaluation was normal in 44.8%; brain calcifications, hydrocephaly, or both conditions were observed in 27.6%, 10.3%, and 17.2%, respectively, of the patients. Patients with cerebrospinal fluid protein≥200mg/dL presented more brain calcifications (p=0.0325). Other sequelae were visual impairment (55.2% of the cases), developmental delay (31.0%), motor deficit (13.8%), convulsion (27.5%), and attention deficit (10.3%). All patients were treated with sulfadiazine, pyrimethamine, and folinic acid, and 55.2% of them exhibited adverse effects. The results demonstrate the significance of the early diagnosis and treatment of toxoplasmosis during pregnancy to reduce congenital toxoplasmosis and its consequences.
authors.affiliation: Department of Clinical Medicine, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil. Electronic address: jaquedc@uel.br.
authors.forename: Jaqueline Dario
authors.initials: JD
authors.lastname: Capobiango
authors.affiliation: Department of Pathological Sciences, Biological Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Regina Mitsuka
authors.initials: RM
authors.lastname: Breganó
authors.affiliation: Department of Veterinary, Agricultural Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Italmar Teodorico
authors.initials: IT
authors.lastname: Navarro
authors.affiliation: Medicine Course, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Claudio Pereira
authors.initials: CP
authors.lastname: Rezende Neto
authors.affiliation: Department of Surgery, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Antônio Marcelo Barbante
authors.initials: AM
authors.lastname: Casella
authors.affiliation: Centro Universitário Filadélfia (UNIFIL), Londrina, PR, Brazil.
authors.forename: Fabiana Maria Ruiz Lopes
authors.initials: FM
authors.lastname: Mori
authors.affiliation: Graduate Program in Veterinary Medicine, Agricultural Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Sthefany
authors.initials: S
authors.lastname: Pagliari
authors.affiliation: Department of Gynecology and Obstetrics, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Inácio Teruo
authors.initials: IT
authors.lastname: Inoue
authors.affiliation: Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Edna Maria Vissoci
authors.initials: EM
authors.lastname: Reiche
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood*; D001938:Brazil; D002648:Child; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy; D012189:Retrospective Studies; D014122:Toxoplasma / Q000276:immunology*; D014125:Toxoplasmosis, Congenital / Q000150:complications* / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan
keywords: Chorioretinitis; Congenital toxoplasmosis; Diagnosis; Toxoplasma gondii