pediatrics
Congenital Toxoplasmosis
Treatment of Congenital Toxoplasmosis
Sometimes spiramycin for pregnant women Pyrimethamine,sulfadiazine, andleucovorin Limited data suggest that treatment of infected women during pregnancy may be beneficial to the fetus ( Treatment references ). Treatment of symptomatic and asymptomatic neonates may improve outcome. Therefore, treatment is begun with oralpyrimethamine(initial loading dose of 2 mg/kg once a day for 2 days followed by 1 mg/kg once a day, maximum 25 mg) and oralleucovorin(10 mg 3 times a week). Oralsulfadiazine(50 mg/kg 2 times a day, maximum 4 g) is begun after neonatal jaundice has resolved. After the initial 6 months of treatment,sulfadiazineandleucovorinare continued at the same dose, butpyrimethamineis given less frequently (only on Monday, Wednesday, and Friday). This regimen is continued for at least 6 more months. All treatment should be overseen by an expert. The use of corticosteroids is controversial and should be determined case by case but may be considered for active chorioretinitis or if CSF protein is > 1 gm/dL. 1.Olariu TR, Press C, Talucod J, et al: Congenital toxoplasmosis in the United States: Clinical and serologic findings in infants born to mothers treated during pregnancy.Parasite26:13, 2019. doi: 10.1051/parasite/2019013 2.Buonsenso D, Pata D, Turriziani Colonna A, et al: Spiramycin andtrimethoprim-sulfamethoxazole combination to prevent mother-to-fetus transmission ofToxoplasma gondiiinfection in pregnant women: A 28-years single-center experience.Pediatr Infect Dis J41(5):e223–e227, 2022. doi: 10.1097/INF.0000000000003469 