Document Detail


Neonatal serologic screening and early treatment for congenital Toxoplasma gondii infection. The New England Regional Toxoplasma Working Group.
MedLine Citation:
PMID:  7818637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Most infants with congenital Toxoplasma gondii infection have no symptoms at birth, but many will have retinal disease or neurologic abnormalities later in life. Early detection and treatment of congenital toxoplasmosis may reduce these sequelae. METHODS: In Massachusetts since January 1986, and in New Hampshire since July 1988, newborns have been screened for intrauterine infection with T. gondii by means of an IgM capture immunoassay of blood specimens routinely collected for screening for metabolic disorders. Congenital infection is confirmed by assays for specific IgG and IgM antibodies in serum from infants and their mothers. For this study, infants with serologic evidence of infection underwent extensive clinical evaluation and received one year of treatment. RESULTS: Through June 1992, 100 of 635,000 infants tested had positive screening tests. Congenital infection was confirmed in 52 infants, 50 of whom were identified only through neonatal screening and not through initial clinical examination. However, after the serologic results became available, more detailed examinations revealed abnormalities of either the central nervous system or the retina in 19 of 48 infants evaluated (40 percent). After treatment, only 1 of 46 children had a neurologic deficit (hemiplegia attributable to a cerebral lesion present at birth). Thirty-nine treated children had follow-up ophthalmologic examinations when one to six years old; four (10 percent) had eye lesions that may have developed postnatally (a macular lesion in one child and minor retinal scars in three). CONCLUSIONS: Routine neonatal screening for toxoplasmosis identifies congenital infections that are subclinical, and early treatment may reduce the severe long-term sequelae.
Authors:
N G Guerina; H W Hsu; H C Meissner; J H Maguire; R Lynfield; B Stechenberg; I Abroms; M S Pasternack; R Hoff; R B Eaton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The New England journal of medicine     Volume:  330     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-06-30     Completed Date:  1994-06-30     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1858-63     Citation Subset:  AIM; IM    
Affiliation:
Division of Infectious Diseases, Children's Hospital, Boston, Mass.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Protozoan / analysis
Central Nervous System Diseases / diagnosis,  etiology
Follow-Up Studies
Humans
Immunoglobulin G / analysis
Immunoglobulin M / analysis
Infant, Newborn
Leucovorin / therapeutic use
Neonatal Screening*
Pyrimethamine / therapeutic use
Retinal Diseases / diagnosis,  etiology
Spiramycin / therapeutic use
Sulfadiazine / therapeutic use
Toxoplasmosis, Congenital / complications,  diagnosis*,  drug therapy*
Chemical
Reg. No./Substance:
0/Antibodies, Protozoan; 0/Immunoglobulin G; 0/Immunoglobulin M; 58-05-9/Leucovorin; 58-14-0/Pyrimethamine; 68-35-9/Sulfadiazine; 8025-81-8/Spiramycin
Comments/Corrections
Comment In:
N Engl J Med. 1994 Nov 24;331(21):1459   [PMID:  7969294 ]
N Engl J Med. 1994 Nov 24;331(21):1458   [PMID:  7969293 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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