In congenital toxoplasmosis with active chorioretinitis and CNS involvement, which is the standard treatment regimen used in the first year of life?

• A Spiramycin alone for 12 months
• B Trimethoprim-sulfamethoxazole for 6 months
• C Pyrimethamine + sulfadiazine + folinic acid for 12 months ✓
• D Clindamycin + pyrimethamine for 6 months

Explanation

Symptomatic congenital toxoplasmosis (chorioretinitis, hydrocephalus, intracranial calcifications) is treated with pyrimethamine + sulfadiazine + leucovorin (folinic acid) for 12 months. Folinic acid is essential to prevent pyrimethamine-induced bone marrow toxicity. Spiramycin is used in pregnant women to reduce placental transmission but does not adequately treat established fetal/neonatal infection. TMP-SMX is an alternative for immunocompromised patients but not the standard neonatal protocol. Clindamycin is used in ocular toxoplasmosis in adults.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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