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Polymerase chain reaction in cerebrospinal fluid for the diagnosis of congenital toxoplasmosis.
[congenital toxoplasmosis]
Congenital
toxoplasmosis
can
result
in
visual
impairment
,
hearing
loss
,
serious
neurologic
sequelae
and
death
in
the
infant
.
We
studied
the
potential
of
the
polymerase
chain
reaction
(
PCR
)
in
cerebrospinal
fluid
(
CSF
)
for
diagnosis
of
congenital
toxoplasmosis
.
For
this
purpose
,
we
studied
both
congenitally
infected
(
diagnosed
clinically
and
serologically
)
and
noninfected
infants
born
to
untreated
mothers
.
The
infants
ranged
in
age
from
0
to
180
days
.
CSF
PCR
was
positive
in
27
of
the
58
(
46
.
5
%
)
congenitally
infected
infants
and
was
negative
in
each
of
the
103
infants
without
congenital
toxoplasmosis
.
The
frequency
of
positive
CSF
PCR
varied
according
to
whether
infants
had
major
clinical
signs
of
the
disease
;
PCR
was
positive
in
70
.
9
%
,
53
.
3
%
and
50
.
9
%
of
those
with
hydrocephalus
,
cerebral
calcifications
and
/
or
eye
disease
,
respectively
.
Of
6
infants
who
were
negative
for
both
IgM
and
IgA
antibodies
,
3
had
a
positive
PCR
in
their
CSF
as
the
confirmatory
test
for
diagnosis
of
congenital
toxoplasmosis
.
IgM
and
IgA
antibodies
and
CSF
PCR
,
when
combined
,
yielded
a
higher
sensitivity
for
diagnosis
of
congenital
toxoplasmosis
when
compared
with
the
performance
of
each
test
alone
.
Our
findings
reveal
that
in
infants
with
clinical
and
serologic
findings
suggestive
of
congenital
toxoplasmosis
and
born
to
untreated
mothers
,
CSF
PCR
has
the
potential
to
increase
the
frequency
of
cases
in
which
the
diagnosis
is
confirmed
.
Diseases
Validation
Diseases presenting
"major clinical signs of the disease"
symptom
congenital toxoplasmosis
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