Congenital toxoplasmosis presenting as central diabetes insipidus in an infant: a case report

Congenital toxoplasmosis has a wide range of presentation at birth varying from severe neurological features such as hydrocephalus and chorioretinitis to a well appearing baby, who may develop complications late in infancy. While neuroendocrine abnormalities associated with congenital toxoplasmosis...

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Bibliographic Details
Published in:BMC research notes 2014-03, Vol.7 (1), p.184-184, Article 184
Main Authors: Mohamed, Sarar, Osman, Abdaldafae, Al Jurayyan, Nasir A, Al Nemri, Abdulrahman, Salih, Mustafa A M
Format: Article
Language:English
Subjects:
Adult
Antibodies, Protozoan - blood
Brain - diagnostic imaging
Brain - parasitology
Brain - pathology
Case Report
Diabetes Insipidus, Neurogenic - complications
Diabetes Insipidus, Neurogenic - congenital
Diabetes Insipidus, Neurogenic - diagnostic imaging
Diabetes Insipidus, Neurogenic - parasitology
Electrolytes
Female
Humans
Immunoglobulin M
Immunoglobulin M - blood
Infant
Radiography
Toxoplasma
Toxoplasma - pathogenicity
Toxoplasma - physiology
Toxoplasmosis, Congenital - complications
Toxoplasmosis, Congenital - diagnostic imaging
Toxoplasmosis, Congenital - parasitology
Toxoplasmosis, Congenital - pathology
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Summary:Congenital toxoplasmosis has a wide range of presentation at birth varying from severe neurological features such as hydrocephalus and chorioretinitis to a well appearing baby, who may develop complications late in infancy. While neuroendocrine abnormalities associated with congenital toxoplasmosis are uncommon, isolated central diabetes insipidus is extremely rare. Here, we report on a female infant who presented with fever, convulsions, and polyuria. Examination revealed weight and length below the 3rd centile along with signs of severe dehydration. Fundal examination showed bilateral chorioretinitis. This infant developed hypernatremia together with increased serum osmolality and decreased both urine osmolality and specific gravity consistent with central diabetes insipidus. Serology for toxoplasma specific immunoglobulin M was high for both the mother and the baby and polymerase chain reaction for toxoplasma deoxyribonucleic acid was positive in the infant confirming congenital toxoplasmosis. Brain computerized tomography scans demonstrated ventriculomegaly associated with cerebral and cortical calcifications. Fluid and electrolyte abnormalities responded to nasal vasopressin therapy. This report highlights central diabetes inspidus as a rare presentation of congenital toxoplasmosis.
ISSN:1756-0500
1756-0500
DOI:10.1186/1756-0500-7-184