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Spinal toxoplasmic arachnoiditis associated with osteoid formation: a rare presentation of toxoplasmosis
T E Cosan1, S Kabukcuoğlu, A Arslantas
1Department of Neurosurgery, Osmangazi University, Eskisehir, Turkey.
Study Design:
An extremely rare presentation of an isolated spinal toxoplasmic arachnoiditis is described.
Objective:
To draw attention to the fact that spinal arachnoid membranes may be a potential reservoir for Toxoplasma gondii.
Summary Of Background Data:
Central nervous system toxoplasmosis is a common manifestation in patients who are immunodeficient. Reports on the spinal toxoplasmosis are rare and focused on spinal cord involvement.
Methods:
An adult patient presented with symptoms of spastic paraparesis that had begun 13 years before admission. Thoracic spinal magnetic resonance imaging showed small lesions in posterior subarachnoid space at Th7-Th8. A Th7-Th8 laminectomy was performed. Intradural-extramedullary lesions were excised.
Results:
Clinical, immunologic, and pathologic examinations showed adhesive spinal arachnoiditis associated with osteoid formation caused by past toxoplasmic infection. There was no impairment of the immunologic defense system.
Conclusion:
Where no causative factor is found in serious spinal adhesive arachnoiditis, the possibility of spinal toxoplasmosis should also be investigated.