Servicio de Neurología Pediátrica, Hospital Militar Central, Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá, D. C., Colombia.
Servicio de Infectología Pediátrica, Hospital Militar Central, Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá, D. C., Colombia.
Biomedica. 2024 Nov 6;44(4):496-509. doi: 10.7705/biomedica.7206.
Congenital toxoplasmosis is a highly prevalent parasitic disease worldwide, with a high burden of disease and neurodevelopmental involvement in pediatric patients.
To describe the clinical sequelae and neurodevelopmental state of pediatric patients with congenital toxoplasmosis at the Hospital Militar Central during 2013 to 2020.
We conducted an observational, descriptive, cross-sectional study with an analytical component, including pediatric patients diagnosed with congenital toxoplasmosis. Patients consulted the Hospital Militar Central from January 2013 to December 2020. The Ages and Stages Questionnaires 3 neurodevelopmental scale was applied to children under six years old.
Forty-five patients with confirmed congenital toxoplasmosis were included, with a mean age of 5.9 years; 60% were male; 11.2 % were symptomatic at birth, and 33% presented chorioretinitis. During the follow-up, 73% presented ophthalmologic sequelae, 64% cerebral calcifications, 4.4% hydrocephalus, 11.2% cerebral palsy, and 13.4% focal epilepsy. In children under six years old, 58% presented neurodevelopmental compromise, and in those over six years old, 62% had cognitive deficits. In this cohort, 68% of the patients received posnatal treatment, with a statistically significant association between not receiving treatment and ophthalmological sequelae (OR = 5.2; p < 0.001).
Congenital toxoplasmosis is associated with important long-term sequelae similar to those described in several Latin American series. These findings highlight the importance of early diagnosis, evaluation, treatment, and timely interdisciplinary follow-up of patients in our country to improve their prognosis.
先天性弓形虫病是一种在全球范围内广泛流行的寄生虫病，在儿科患者中具有较高的疾病负担和神经发育受累。
描述 2013 年至 2020 年期间，在中央军事医院（Hospital Militar Central）接受治疗的先天性弓形虫病儿科患者的临床后遗症和神经发育状况。
我们进行了一项观察性、描述性、横断面研究，具有分析成分，包括被诊断为先天性弓形虫病的儿科患者。患者于 2013 年 1 月至 2020 年 12 月期间在中央军事医院就诊。年龄和阶段问卷 3 神经发育量表适用于 6 岁以下的儿童。
共纳入 45 例确诊的先天性弓形虫病患者，平均年龄为 5.9 岁；60%为男性；11.2%出生时出现症状，33%出现脉络膜视网膜炎。在随访期间，73%出现眼部后遗症，64%出现脑钙化，4.4%出现脑积水，11.2%出现脑瘫，13.4%出现局灶性癫痫。6 岁以下儿童中，58%存在神经发育障碍，6 岁以上儿童中，62%存在认知障碍。在该队列中，68%的患者接受了产后治疗，未接受治疗与眼部后遗症之间存在统计学显著关联（OR=5.2；p<0.001）。
先天性弓形虫病与类似的重要长期后遗症相关，与几个拉丁美洲系列研究中的描述相似。这些发现强调了在我国早期诊断、评估、治疗和及时进行跨学科随访患者的重要性，以改善他们的预后。
