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. 2010 Sep 7;3(4):439-42.
doi: 10.1007/s12245-010-0207-7.

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature

Carlos Garcia-Gubern  1 , Carmen R Fuentes, Lissandra Colon-Rolon, Daniel Masvidal
Affiliations

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature

Carlos Garcia-Gubern et al. Int J Emerg Med. .

Abstract

Approximately 10% of patients with AIDS present with some neurological deficit as their initial complaint, and up to 80% will have CNS involvement during the course of their disease. Toxoplasmosis is the most common cause of cerebral mass lesions in patients with AIDS, but appears to be an uncommon cause of spinal cord disease. The incidence of myelopathy may be as high as 20%, with 50% of the cases reported post-mortem. We present a unique case of spinal cord disease as the initial presentation of AIDS. We also present a comprehensive literature review of this topic, its diagnosis and treatment. This is a retrospective chart review case report. After a detailed case presentation, several diagnostic and therapeutic aspects of this unique case are thoroughly discussed. Although spinal cord toxoplasmosis is uncommon, it has been suggested that most patients with AIDS that present with evolving myelopathy, characterized by extremity weakness, sensory involvement, spinal cord enlargement, enhancing lesions in brain or spinal cord CT or MRI, have toxoplasmic myelitis.

Keywords: AIDS; Emergency department; Spinal toxoplasmosis.

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Figures

Fig. 1
Fig. 1
Initial MRI: notice the abnormal spinal cord swelling cervical and at cauda equina
Fig. 2
Fig. 2
Normal F/U study
See this image and copyright information in PMC

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