Congenital toxoplasmosis with brain lesions despite antenatal treatment

BACKGROUND: Maternal toxoplasmosis seroconversion during the first trimeste r of pregnancy raises an important risk of toxoplasmic fetopathy. CASE REPORT: Primary toxoplasmosis was identified between 9 and 17 weeks of gestation. PCR analysis of the amniotic fluid confirmed fetal infection. T he mother was given a sulfadoxine-piremythamine combination and monthly ult rasonographic surveillance was initiated. At birth, the female infant was f ound to have diffuse cortical lesions and a chorioretinitis compatible with toxoplasmic fetopathy. She was given sulfadoxine-piremythamine. At 2 years , the clinical and neuroradiological course has been favorable. CONCLUSION: Despite antenatal and postnatal treatment and despite ultrasono graphic surveillance, it is difficult to pre diet the course of congenital toxoplasmosis; This case illustrates the importance of informing parents of the risk and the requirement for careful follow-up after antenatal diagnos is of first-trimester toxoplasmosis.