Management of Congenital Toxoplasmosis

2014
Prompt diagnosis and rapid initiation of medical treatment are critical for the best outcomes in infants with congenital toxoplasmosis. This is important for pregnant women, fetuses, and infants, including those with active retinitis and choroidal neovascularmembranes. For hydrocephalus, prompt placement of a ventriculoperitoneal shunt is key for improved outcomes. Pyrimethamineand Sulfadiazinewith Leucovorin are first-line medicines. For later recurrences of active retinitis, Azithromycinor Clindamycinare sometimes substituted for Sulfadiazineas second-line treatments, given with Pyramethamine. Following resolution of active retinitis, these medicines may be useful without Pyrimethaminefor suppression and avoid the risk of hypersensitivity from Trimethoprim/ Sulfamethoxazole. Antibody to VEGF, in conjunction with antimicrobial therapy, results in resolution of choroidal neovascularmembranes. Serologic screening of seronegative pregnant women to detect primary infection during gestation, and facilitating medicine administration and thereby preventing or treating fetal infection, is an optimal, apparently cost-effective, means to reduce disease. Definitively curative medicines currently being developed likely will improve future management and outcomes of this disease.
    • Correction
    • Source
    • Cite
    • Save
    210
    References
    27
    Citations
    NaN
    KQI
    []
    Baidu
    map