Evidence that prevention, diagnosis and treatment of toxoplasmosis is beneficial developed as follows: antiparasitic agents abrogate Toxoplasma gondii tachyzoite growth, preventing destruction of infected, cultured, mammalian cells and cure active infections in experimental animals, including primates. They treat active infections in persons who are immune-compromised, limit destruction of retina by replicating parasites and thereby treat ocular toxoplasmosis and treat active infection in the fetus and infant. Outcomes of untreated congenital toxoplasmosis include adverse ocular and neurologic sequelae described in different countries and decades. Better outcomes are associated with treatment of infected infants throughout their first year of life. Shorter intervals between diagnosis and treatment in utero improve outcomes. A French approach for diagnosis and treatment of congenital toxoplasmosis in the fetus and infant can prevent toxoplasmosis and limit adverse sequelae. In addition, new data demonstrate that this French approach results in favorable outcomes with some early gestation infections. A standardized approach to diagnosis and treatment during gestation has not yet been applied generally in the USA. Nonetheless, a small, similar experience confirms that this French approach is feasible, safe, and results in favorable outcomes in the National Collaborative Chicago-based Congenital Toxoplasmosis Study cohort. Prompt diagnosis, prevention and treatment reduce adverse sequelae of congenital toxoplasmosis.Key words: congenital toxoplasmosis -prevention -treatment antimicrobial treatment of T. gondii in tissue culture and animal models eliminates actively replicating parasites and leads to prevention or resolution of signs of disease in these models (Eyles & Coleman 1953a, b, 1955a, b, Frenkel & Hitchings 1957, Garin et al. 1968, Brus et al. 1971, Beverley et al. 1973, Feldman 1973, Sheffield & Melton 1975, Grossman & Remington 1979, Garin & Paillard 1984, Mack & McLeod 1984, Picketty et al. 1990, Hohlfels et al. 1994, Schoondermarkvan de Ven et al. 1995, Derouin 2001, Meneceur et al. 2008; treatment of ocular toxoplasmosis, toxoplasmosis in immune-compromised persons and of congenital toxoplasmosis in humans abrogates symptoms and signs of active infection and improves outcomes (Perkins et al. 1956, Kräubig 1963, Thalhammer 1969, Couvreur et al. 1984a, 1993, Desmonts & Couvreur 1984, Daffos et al. 1988, Hohlfeld et al. 1989, 1994a, b, Dannemann et al. 1992, 2006a, Torre et al. 1998, Boyer et al. 2000, Thulliez 2001, Brézin et al. 2003, Kim 2006, Berrebi et al. 2007, Petrof & McLeod 2002, SY-ROCOT et al. 2007, the more rapidly human congenital toxoplasmosis is diagnosed and treated, the shorter the time available for tissue destruction by the parasite and thus the better the outcomes , SYROCOT et al. 2007; and detection of the infection acquired during the gestation of the fetus and rapid initiation of treatment, is often associated with favorable outcomes (Daffos et al. 1988, Hohlfeld et al. 1989, Fo...

Women infected with toxoplasmosis during pregnancy do not present symptoms in most cases, but the consequences of the congenital infection may be severe for the unborn child. Fetal damage can range from asymptomatic to severe neurological alterations to retinal lesions prone to potential flare up and relapses lifelong. Despite the possible severity of outcome, congenital toxoplasmosis (CT) is a neglected disease. There is no consensus regarding screening during pregnancy, prenatal/postnatal treatment or short or medium term follow-up. Since 1992, France has offered systematic serological testing to non-immune pregnant women, monthly until delivery. Any maternal infection is thus detected; moreover, diagnosis of congenital infection can be made at birth and follow-up can be provided. “Guidelines” drawn up by a multidisciplinary group are presented here, concerning treatment, before and after birth. The recommendations are based on the regular analysis of the literature and the results of the working group. The evaluation of the recommendations takes into account the robustness of the recommendation and the quality of the evidence.

These data suggest that 1) preterm neonates are sensitive to changes in plasma glucose concentration, but proinsulin processing to insulin is partially defective in hyperglycemic preterm neonates; 2) hyperglycemic neonates are relatively resistant to insulin because higher insulin levels are needed to achieve euglycemia in this group compared with normoglycemic neonates. These results also show that insulin infusion is beneficial in extremely preterm infants with transient hyperglycemia.

This study demonstrates that if outcome of isolated ACC is favorable, a long follow-up is necessary: with age, IQ in the lower range and behavioral troubles are linked to difficulties in school.

A delay of >8 weeks between maternal seroconversion and the beginning of treatment, female gender, and especially cerebral calcifications are risk factors for retinochoroiditis during the first 2 years of life in infants treated for congenital toxoplasmosis.