Journal of Neuroinfectious Diseases
Open Access

Case Report

Spinal Cord Lesions in Congenital Toxoplasmosis Demonstrated with Neuroimaging, Including Their Successful Treatment in an Adult

Delilah Burrowes¹ Kenneth Boyer² Charles N. Swisher³ A. Gwendolyn Noble⁴ Mari Sautter⁵ Peter Heydemann² Peter Rabiah³ Daniel Lee⁵ Rima McLeod^5,6,* and the Toxoplasmosis Study Group

¹Department of Radiology, The University of Chicago, Chicago, IL

²Department of Pediatrics, Rush University Medical Center, Chicago, IL

³Department of Neurology, Children’s Memorial Hospital, Northwestern University, Chicago, IL

⁴Department of Ophthalmology, Children’s Memorial Hospital, Chicago, IL

⁵Department of Surgery, Division of Ophthalmology and Visual Sciences, The University of Chicago, Chicago, IL

⁶Departments of Pediatrics, Pathology, Committees on Immunology, Molecular Medicine, and Genetics, and the College, The University of Chicago, Chicago, IL

*Corresponding Author:

Rima McLeod
Department of Surgery, Division
of Ophthalmology and Visual Sciences
The University of Chicago, Chicago, IL
E-mail: rmcleod@uchicago.edu

Received Date: 5 December 2011 Revised Date: 22 December 2011 Accepted Date: 25 December 2011

Neuroimaging studies for persons in the National Collaborative Chicago-Based Congenital Toxoplasmosis Study (NCCCTS) with symptoms and signs referable to the spinal cord were reviewed. Three infants had symptomatic spinal cord lesions, another infant a Chiari malformation, and another infant a symptomatic peri-spinal cord lipoma. One patient had an unusual history of prolonged spinal cord symptoms presenting in middle age. Neuroimaging was used to establish her diagnosis and response to treatment. This 43 year-old woman with congenital toxoplasmosis developed progressive leg spasticity, weakness, numbness, difficulty walking, and decreased visual acuity and color vision without documented re-activation of her chorioretinal disease. At 52 years of age, spinal cord lesions in locations correlating with her symptoms and optic atrophy were diagnosed with 3 Tesla MRI scan. Treatment with pyrimethamine and sulfadiazine decreased her neurologic symptoms, improved her neurologic examination, and resolved her enhancing spinal cord lesions seen on MRI.

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