Congenital toxoplasmosis and audiological outcome: from a case series to a suggestion of patient-based schedule.

Autor:	Salomè S; Division of Neonatology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy., Malesci R; Unit of Audiology, Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples 'Federico II', Naples, Italy., Delle Cave V; Division of Neonatology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy., Amitrano A; Division of Neonatology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy., Gammella R; Division of Neonatology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy., Fanelli F; Division of Neonatology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy., Capone E; Division of Neonatology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy., Capasso L; Division of Neonatology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy., Fetoni AR; Unit of Audiology, Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples 'Federico II', Naples, Italy., Raimondi F; Division of Neonatology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2024 Jan 04; Vol. 11, pp. 1297208. Date of Electronic Publication: 2024 Jan 04 (Print Publication: 2023).
DOI:	10.3389/fped.2023.1297208
Abstrakt:	Introduction: Sensorineural hearing loss (SNHL) has been suggested to be possibly related to congenital toxoplasmosis (CT), although its prevalence varies from 0% to 26%. This variance appears to be dependent especially on early timing of treatment. However, the available data are based on outdated studies conducted on small groups of patients that lack homogeneity. Therefore, to establish evidence-based guidelines for audiologic monitoring in CT, we conducted a comprehensive evaluation of a large case series over a long period of time. Patients and Methods: This is a single-center, retrospective cohort that enrolled all infants and children who were exposed in utero to Toxoplasma gondii and/or congenitally infected between September 1980 and December 2022. They underwent standard serial audiological evaluations to detect possible SNHL at an early stage. The first evaluation was performed during the initial assessment to define the onset of congenital toxoplasmosis, with another evaluation conducted at least at 12 months of life. Results: We collected data from 1,712 patients, and 183 (10.7%) were diagnosed with CT. Among these cases, 78 children (42.6%) presented with symptomatic CT at the onset, exhibiting ocular findings (21.1%), clinical cerebral manifestations (6.1%), and/or abnormal findings on neuroimaging (35.5%). Therapy was administrated at the onset in 164 patients (89.6%) with 115 of them starting treatment prior to 2.5 months of age (0-388, median 32.00 ± 92.352 days of life). Only one patient presented with SNHL at the onset, but this was apparently unrelated to CT. The median number of audiological assessments was 2.2 ± 1.543 (2-10). No patients developed any grade of delayed hearing loss, both in treated and untreated groups. The median age at last audiological evaluation was 2.3 ± 2.18 years (1-8), although the median follow-up period was 12.4 years (±6.3), ranging from 1 to 27 years. Conclusions: Based on these data, it appears that SNHL may be less frequent in CT than previously assumed. We recommend conducting an audiological assessment at the onset (within the first 2.5 months of life) to comprehensively define the type of CT onset, and then conducting another evaluation within 9 months of life. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (© 2024 Salomè, Malesci, Delle Cave, Amitrano, Gammella, Fanelli, Capone, Capasso, Fetoni and Raimondi.)
Databáze:	MEDLINE
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