EC Paediatrics

Congenital infections may present with mortality, morbidity or similar sequelae. Here, we present a 13-months-old girl who was initially diagnosed with congenital toxoplasmosis based on findings detected during routine eye examination and who was additionally diagnosed with congenital cytomegalovirus infection after sensorineural hearing loss, periventricular calcification, and high CMV copy number in urine were observed during etiological screening. The patient was treated simultaneously for both congenital toxoplasmosis (pyrimethamine, folinic acid, sulphadiazine) and congenital cytomegalovirus (valganciclovir) infection. The first control hearing test performed after the treatment process was completed without complications yielded bilateral normal results. The presence of coinfection should be kept in mind in patients diagnosed with any TORCH infection and the effect of early treatment in preventing late sequelae should not be forgotten.

 Keywords: Congenital Toxoplasmosis; Congenital Cytomegalovirus; Treatment; Sequel

1. Neu N., et al. “TORCH infections”. Clinics in Perinatology 1 (2015): 77-103.
2. American Academy of Pediatrics. “Toxoplasma gondii infections (Toxoplasmosis)”. In: Red Book: 2015 Report of the Committee on Infectious Diseases, 30^th, Kimberlin DW (Ed), American Academy of Pediatrics, Elk Grove Village, IL (2015): 787.
3. Eichenwald HF. “A study of congenital toxoplasmosis with particular emphasis on clinical manifestations, sequelae and therapy”. In: Human Toxoplasmosis, Siim JC (Ed), Munksgaard, Copenhagen (1959).
4. American Academy of Pediatrics. “Toxoplasma gondii infections (Toxoplasmosis)”. In: Red Book: 2024 Report of the Committee on Infectious Diseases, 33^rd, Kimberlin D /Ed), American Academy of Pediatrics, Itasca, IL (2024): 867.
5. Wallon M., et al. “Ophthalmic outcomes of congenital toxoplasmosis followed until adolescence”. Pediatrics 3 (2014): e601-e608.
6. Luck SE., et al. “Congenital cytomegalovirus: A European expert consensus statement on diagnosis and management”. The Pediatric Infectious Disease Journal 12 (2017): 1205-1213.
7. Dreher AM., et al. “Spectrum of disease and outcome in children with symptomatic congenital cytomegalovirus infection”. Journal of Pediatrics 4 (2014): 855-859.
8. Leruez-Ville M., et al. “Prospective identification of congenital cytomegalovirus infection in newborns using real-time polymerase chain reaction assays in dried blood spots”. Clinical Infectious Diseases 5 (2011): 575.
9. Leruez-Ville M., et al. “Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI)”. Lancet Regional Health - Europe 40 (2024): 100892.
10. McAuley JB., et al. “Toxoplasmosis”. In: Feigin and Cherry’s Textbook of Pediatric Infectious Diseases, 7^th, Cherry JD, Harrison GJ, Kaplan SL, et al (Eds), Elsevier Saunders, Philadelphia (2014): 2987.
11. Lanzieri TM., et al. “Long-term outcomes of children with symptomatic congenital cytomegalovirus disease”. Journal of Perinatology 7 (2017): 875-880.