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.
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: Tze Guan Tan; Ernest Mui; Hua Cong; William H Witola; Alexandre Montpetit; Stephen P Muench; John Sidney; Jeff Alexander; Alessandro Sette; Michael E Grigg; Ajesh Maewal; Rima McLeod Journal: Vaccine Date: 2010-03-26 Impact factor: 3.641
Authors: Alina Fomovska; Richard D Wood; Ernest Mui; Jitenter P Dubey; Leandra R Ferreira; Mark R Hickman; Patricia J Lee; Susan E Leed; Jennifer M Auschwitz; William J Welsh; Caroline Sommerville; Stuart Woods; Craig Roberts; Rima McLeod Journal: J Med Chem Date: 2012-09-26 Impact factor: 7.446
Authors: Anna M H Korver; Richard J H Smith; Guy Van Camp; Mark R Schleiss; Maria A K Bitner-Glindzicz; Lawrence R Lustig; Shin-Ichi Usami; An N Boudewyns Journal: Nat Rev Dis Primers Date: 2017-01-12 Impact factor: 52.329
Authors: Wesley C Van Voorhis; J Stone Doggett; Marilyn Parsons; Matthew A Hulverson; Ryan Choi; Samuel L M Arnold; Michael W Riggs; Andrew Hemphill; Daniel K Howe; Robert H Mealey; Audrey O T Lau; Ethan A Merritt; Dustin J Maly; Erkang Fan; Kayode K Ojo Journal: Exp Parasitol Date: 2017-01-05 Impact factor: 2.011
Authors: Gang Cheng; Stephen P Muench; Ying Zhou; Gustavo A Afanador; Ernest J Mui; Alina Fomovska; Bo Shiun Lai; Sean T Prigge; Stuart Woods; Craig W Roberts; Mark R Hickman; Patty J Lee; Susan E Leed; Jennifer M Auschwitz; David W Rice; Rima McLeod Journal: Bioorg Med Chem Lett Date: 2013-02-13 Impact factor: 2.823
Authors: S E Jamieson; A L Peixoto-Rangel; A C Hargrave; L-A de Roubaix; E J Mui; N R Boulter; E N Miller; S J Fuller; J S Wiley; L Castellucci; K Boyer; R G Peixe; M J Kirisits; L de Souza Elias; J J Coyne; R Correa-Oliveira; M Sautter; N C Smith; M P Lees; C N Swisher; P Heydemann; A G Noble; D Patel; D Bardo; D Burrowes; D McLone; N Roizen; S Withers; L M G Bahia-Oliveira; R McLeod; J M Blackwell Journal: Genes Immun Date: 2010-06-10 Impact factor: 2.676
Authors: Delilah Burrowes; Kenneth Boyer; Charles N Swisher; A Gwendolyn Noble; Mari Sautter; Peter Heydemann; Peter Rabiah; Daniel Lee; Rima McLeod Journal: J Neuroparasitology Date: 2012-03
Authors: Gustavo A Afanador; Stephen P Muench; Martin McPhillie; Alina Fomovska; Arne Schön; Ying Zhou; Gang Cheng; Jozef Stec; Joel S Freundlich; Hong-Ming Shieh; John W Anderson; David P Jacobus; David A Fidock; Alan P Kozikowski; Colin W Fishwick; David W Rice; Ernesto Freire; Rima McLeod; Sean T Prigge Journal: Biochemistry Date: 2013-12-13 Impact factor: 3.162