PEDIATRICS Vol. 1 No. 4 April 1948, pp. 478-494
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TOXOPLASMIC ENCEPHALOMYELITIS

A Clinical Report of Six Cases

GABRIEL A. SCHWARZ M.D.1, ELIZABETH KIRK ROSE M.D.2, and WILFRED E. FRY M.D.3

1 The Department of Neurology, School of Medicine, University of Pennsylvania, Philadelphia, Pa.
2 The Department of Pediatrics, School of Medicine, University of Pennsylvania, Philadelphia, Pa.
3 The Department of Ophthalmology, School of Medicine, University of Pennsylvania, Philadelphia, Pa.

Six cases of toxoplasmic encephalomyelitis in infants and children are presented. In all of these cases, the diagnosis was made on clinical grounds alone. All of these patients are still living. A description of the pathologic findings in the retina of one case is given.

In an analysis of these six cases it was noted that the ocular findings were the most constantly occurring of all the features. Mental retardation was also noted in all six cases. Cerebral calcifications were found in all but one of the cases.

The cases already reported in the literature are enumerated and a review of the clinical features of toxoplasmic encephalomyelitis is given. The chief features noted in the infantile form are: (1) onset at birth or soon after, (2) convulsions, (3) bilateral communicating hydrocephalus, (4) bilateral focal chorioretinitis usually involving both macula and (5) multiple calcifications in the brain.

It is our feeling that this constellation of signs and symptoms should suggest the diagnosis of toxoplasmosis without recourse to the isolation of the protozoan or the securing of positive neutralization reactions.

Submitted on January 29, 1948