Ascending paralysis due to myelitis in a newborn with congenital toxoplasmosis

We present a female neonate in her second week of life with borderline microcephaly, microphthalmia and progressive ascending sensory and motor deficit leading to complete paralysis with respiratory failure and death at 27 days of age. Neurological imaging revealed, in addition to cerebral atrophy,...

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Bibliographic Details
Published in:Journal of the neurological sciences 1996-07, Vol.139 (1), p.156-159
Main Authors: Al Shahwan, Saad, Rossi, Marco L.M., Al Thagafi, Mohamed Aabed
Format: Article
Language:English
Subjects:
Ascending paraplegia
Atrophy
Biological and medical sciences
Brain - diagnostic imaging
Brain - pathology
Brain atrophy
Cerebrospinal fluid (CSF) cytology
Congenital toxoplasmosis
Fatal Outcome
Female
Human protozoal diseases
Humans
Hydrocephalus
Infant, Newborn
Infectious diseases
Magnetic Resonance Imaging
Medical sciences
Microcephaly
Microphthalmia
Myelitis
Myelitis - pathology
Myelitis - physiopathology
Paralysis - etiology
Paralysis - pathology
Paralysis - physiopathology
Parasitic diseases
Protozoal diseases
Tomography, X-Ray Computed
Toxoplasmosis
Toxoplasmosis, Congenital - diagnostic imaging
Toxoplasmosis, Congenital - pathology
Toxoplasmosis, Congenital - physiopathology
Tropical medicine
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Summary:We present a female neonate in her second week of life with borderline microcephaly, microphthalmia and progressive ascending sensory and motor deficit leading to complete paralysis with respiratory failure and death at 27 days of age. Neurological imaging revealed, in addition to cerebral atrophy, marked hydrocephalus, ependymal basal ganglia calcification, leptomeningeal enhancement, and patchy myelitis throughout the entire spinal cord. CSF cytological examination revealed the presence of a mononuclear pleocytosis with Toxoplasma gondii trophozoites free in the CSF and within the cytoplasm of some macrophages, and a 100-fold raised protein content. To our knowledge, this is the first reported case of clinical acute spinal cord involvement in congenital toxoplasma infection, proven by the presence of toxoplasma trophozoite in the CSF.
ISSN:0022-510X
1878-5883
DOI:10.1016/0022-510X(96)00047-0