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Case Reports
. 2014 Oct;6(4):178-81.
doi: 10.4103/0974-777X.145248.

Toxoplasmosis of spinal cord in acquired immunodeficiency syndrome patient presenting as paraparesis: a rare entity

Sachin R Agrawal  1 , Vinita Singh  1 , Sheetal Ingale  1 , Ajeet Prasad Jain  1
Affiliations
Case Reports

Toxoplasmosis of spinal cord in acquired immunodeficiency syndrome patient presenting as paraparesis: a rare entity

Sachin R Agrawal et al. J Glob Infect Dis. 2014 Oct.

Abstract

Although brain has been the most common site for toxoplasma infection in acquired immunodeficiency syndrome patients, involvement of spinal cord by toxoplasma has been rarely found. Spinal cord toxoplasmosis can present as acute onset weakness in both lower limbs associated with sensory and bladder dysfunction. A presumptive diagnosis can be made in patients with CD4 count <100/mm(3) based on a positive serum Toxoplasma gondii IgG antibodies, no recent prophylaxis against toxoplasmosis, intramedullary ring enhancing lesion in spinal cord supported by similar lesions in brain parenchyma. Institutions of antitoxoplasma treatment in such patients result in prompt clinical response and therefore avoiding the need of unnecessary invasive diagnostic tests. Here, we report a case of toxoplasmic myelitis in immunocompromised patient presenting as myelopathy who showed significant clinical improvement after starting antitoxoplasma treatment. Hence toxoplasmic myelitis should be considered in toxoplasma seropositive immunocompromised patients presenting as myelopathy and imaging studies showing ring enhancing intramedullary lesion.

Keywords: Acquired immunodeficiency syndrome; Immunocompromised; Paraparesis; Spinal toxoplasmosis.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Gadolinium enhanced magnetic resonant image of spine showing intramedullary ring enhancing lesion (1.5 cm × 1.1 cm) at T9 vertebral level
Figure 2
Figure 2
Gadolinium enhanced magnetic resonant image of the brain showing single ring enhancing intra-axial lesion in the occipital lobe
See this image and copyright information in PMC

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