Atypical congenital toxoplasmosis presenting with neonatal jaundice and central nervous system involvement: a case report and therapeutic challenges to limited access to first-line anti-toxoplasma medications - Summary - MDSpire
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Atypical congenital toxoplasmosis presenting with neonatal jaundice and central nervous system involvement: a case report and therapeutic challenges to limited access to first-line anti-toxoplasma medications
To report a case of congenital toxoplasmosis (CT) in a neonate presenting with jaundice and to highlight treatment challenges due to limited access to first-line therapies.
Approach:
Case Presentation: A 9-day-old male infant presented with persistent jaundice. He was born at 39 +4 weeks' gestation, with a prenatal history notable for maternal cat exposure and treated hypothyroidism. Initial serological tests were positive for Toxoplasma gondii, and subsequent evaluations revealed chorioretinitis, cerebral edema, and auditory dysfunction.
Key Findings:
Isolated neonatal jaundice can be an initial sign of congenital toxoplasmosis.
The infant had subclinical chorioretinitis and central nervous system involvement.
Initial treatment with azithromycin and trimethoprim-sulfamethoxazole showed no improvement, while standard therapy with pyrimethamine, sulfadiazine, and folinic acid led to rapid clinical improvement.
Interpretation:
Congenital toxoplasmosis should be considered in neonates with unexplained jaundice, necessitating comprehensive evaluations.
Limitations:
Limited access to first-line anti-parasitic agents may hinder effective treatment.
The case is based on a single patient experience, which may not be generalizable.
Conclusion:
Early recognition and treatment of congenital toxoplasmosis are crucial for better clinical outcomes.
