Congenital toxoplasmosis – clinico-evolutive aspects

Abstract

Introduction. Congenital toxoplasmosis represents an im­por­tant cause of infant morbidity and mortality. The etio­lo­gical agent is a largely spread parasite microorganism, To­xo­­plas­ma gondii. Fetal infection is possible only when the preg­nant patient contracts the disease during pregnancy. The to­po­graphy of fetal lesions involves especially the brain and the eyes. The most common form of the disease is re­pre­sen­ted by congenital encephalomyelitis, manifested by hy­dro­ce­phalus, microcephaly, microphthalmia, typical signs of cerebellar suffering and ocular impairment. The definitive diag­nosis involves the detection of specific IgM antibodies in the patient’s blood, the persistence of IgG antibodies after the age of 1 year old, or the detection by PCR of the parasite DNA in the blood and cerebrospinal fluid. Objective. The paper presents the medical evolution of a case of congenital toxoplasmosis. Materials and method. We present the case of a male baby, 12 months old, institutionalized after birth, who was diagnosed with congenital toxoplasmosis at the age of 6 months old. Results. The evolution was un­fa­vo­ra­ble, the patient developing hydrocephalus, which ne­ces­si­ta­ted the mounting of a ventriculoperitoneal shunt, and frequent meningitis episodes, of both viral and bacterial etiology. There­after, the patient developed spas­tic tetraparesis, ge­ne­ral­ized epilepsy, profound men­tal retardation and mul­ti­ple respiratory infections. Con­clu­sions. The clinical mani­festa­tions in congenital toxo­plas­mo­sis range from asymptomatic or mild-medium disease forms to severe forms (4%), with serious neurological sequelae or even death.