Prognosis

Non-eye infection in a patient who is immunocompetent

Infection is usually mild and prognosis is good without treatment.

Chorioretinitis

Chorioretinitis responds variably to treatment. While patients in whom vision is threatened should receive treatment, a review of available trials found no benefit of treatment on duration of symptoms or on severity of disease.[59] Risk for recurrence is high, and treatment of symptomatic episodes does not reduce the risk for recurrent disease. Thus, frequent ophthalmological follow-up is necessary. In addition, patients may benefit from chronic suppression with trimethoprim/sulfamethoxazole if they develop frequent recurrences.[59][66]

Infection in a patient who is immunosuppressed

Infection is lifelong. Thus, if a patient remains immunocompromised, he or she remains at risk for symptomatic disease and should continue to take chronic suppressive therapy. Initiating antiretroviral therapy in HIV-infected patients, with a subsequent rise in CD4+ T lymphocytes to >200 cells/microlitre or >100 cells/microlitre with undetectable HIV plasma levels, is the only means by which chronic suppressive therapy may safely be stopped.

Infection during pregnancy

Patients may stop treatment after delivery. Women who become infected during pregnancy are often asymptomatic and will not become symptomatic once treatment is stopped. They are not at risk for transmission of infection during subsequent pregnancies unless there is underlying immunosuppression. Antenatal screening and improvement in antenatal diagnosis are associated with a significant reduction in the rate of congenital infection and better outcome at 3 years of age in children who are infected.[11][67]

Congenital disease

Many cases are subclinical at birth. More subtle findings (e.g., changes in IQ), intellectual disability, seizures, palsies, or deafness may develop later in life. In addition, these patients are at risk for developing chorioretinitis, even into the second decade of life. Thus, congenitally infected children should receive close follow-up from a paediatric neurologist and an ophthalmologist.[11][37]

Use of this content is subject to our disclaimer