CONGENITAL TOXOPLASMOSIS - MANAGEMENT AND PROGNOSIS

Any patient with congenital toxoplasmosis even subclinical must be treated during the first year of life. This is warranted by the documented risk of more of less late secondary progress of the disease : most often ocular flare-ups and sometimes neurological signs - by the occurence of secondary antibody rise in more than 70 % of the patients - by the possibility of late local antibody synthesis in aqueous humor of the eye or in cerebro-spinal fluid. The pyrimethamine-sulfadiazine combination is the treatment of choice. It seems that the more the patients are treated the best are the results. Treatment of ocular flare-ups with the pyrimethamine sulfa-drug combination plus steroid therapy gave encouraging results. On the basis of accumulated da ta, it looks like diagnostic progress and a series of preventive measures undertaken these last 4 decades led to almost complete eradication of severe clinical pattern of the disease with neurological involvement.