Dr. Silverman: I shall present the history of an infant who was admitted to our premature nursery on May 9, 1956. This Puerto Rican male infant was born during the thirty-sixth week of an uneventful pregnancy. An antenatal serologic test for syphilis was negative. Delivery was spontaneous. Birth weight was 1070 gm. Physical examination on admission to the nursery revealed the liver to be 1 cm below the right costal margin and the spleen was firm, 1 cm below the left costal margin. Nothing else worthy of comment was noted and the infant was managed in a routine manner. The immediate newborn period was entirely uneventful, specifically neither petechiae nor unusual degree of icterus were noted. The ocular fundi were examined, as a matter of routine, during the third and fifth weeks of life and they were described as normal.
During the sixth week of life, when the infant weighed 2080 gm, it was suddenly noted that the abdomen was quite distended. Examination at this time disclosed marked hepatosplenomegaly, both organs were firm. Again neither icterus nor petechiae were noted. There appeared to be some difficulty in swallowing. Roentgenograms of the chest at this time were normal and of the skull revealed intracranial calcification which was displayed in a pattern that seemed to outline dilated lateral ventricles. Lumbar puncture yielded cerebrospinal fluid which was negative except for protein of 198 mg/100 ml. The urine and cerebrospinal fluid were examined for the cells characteristic of cytomegalic inclusion disease and none were found.
Funduscopic examination at this time disclosed an area of chorioretinitis in the right eye. It was presumed at this time that the infant had toxoplasmosis.
- Copyright © 1958 by the American Academy of Pediatrics