256: TORCH INFECTIONS

PATIENT PRESENTATION

A 7-month-old male child is brought to a physical therapist to be evaluated for a delay in motor skills acquisition. According to parental report, he has been slower to achieve motor milestones than his siblings. He has recently begun rolling from supine to prone and prone to supine and reportedly is beginning to sit momentarily. He was diagnosed with chorioretinitis shortly after birth which was successfully treated with antibiotics and steroids, although he continues to demonstrate mild photosensitivity. Parents report that he had seizures in the first few weeks of life that are well controlled on his current medication. Prenatal maternal history is positive for mild flu-like symptoms in the second trimester that went unreported.

Upon physical examination, the infant plays in supine, while holding a small toy with both hands. He rolls to prone in both directions to secure a toy held out of reach. He is vocally responsive to his parents and the examiner. He smiles and turns toward a musical toy when it is introduced. Minimal redness of his eyes with some excess tearing is noted. When placed in sitting, propped forward on extended upper extremities, he is able to maintain the position briefly before falling forward. Laboratory studies revealed antibodies against toxoplasmosis. A recent brain scan revealed cerebral calcifications.