Santa Casa of Sao Paulo is a tertiary hospital in downtown S. Paulo. During the period of 1991 to 1995 we prospectivelly studied 43 children, age between 0 and 14 years old with diagnosis of congenital toxoplasmosis. The diagnosis inclusion criteria were: Positive sorology for toxoplasmosis (Imunocapture ELISA_ IgM), Increasing IgG titers for toxoplasmosis, presence of cororetinitis and presence of intracerebral calcifications at the radiological evaluation. The distribuition of diagnosis age was: 11.6% at the first month, 25.5% between the second and sixth month, 23.2% between 7 months and two years old and 39.5% after two years old. Of the 16 children diagnosed in the first six months of age, 8 had positive IgM for toxoplasmosis, two had negative IgM but the mothers had positive IgM and 6 had only increasing IgG titers. None children diagnosed after six months of age had positive IgM. Most of the children (84%) had birth weight above 2.500g. The most frequent complaint at diagnosis was visual alteration like nistagmus or strabismus (67.4%). Presence of cats at home was the major predisponent risk factor for toxoplasmosis acquisition during pregnancy and was detected in 44% of the cases. The most important clinical finding was: cororetinitis that was present in 41 children(95.3%), affecting both eyes in 36 (83.7%) children. Two children developed corioretinitis at the follow-up despite, being treated in the first year of life after more than one year of the primary diagnosis, and five children reactivated the oftalmic lesion after two years of follow-up. Intraparenquimatous calcifications were present in 76.7% of the children.Neurologic alterations like delayed skills acquisition, hydrocephalus, mycrocephalus or seizures were present in 51.1% of the children. Audiologic deficit was present in 2 of the 16 children tested.
In conclusion congenital toxoplasmosis is important in our setting and sorologic screenig may be done in all pregnant women as a part of antenatal care.
