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Toxoplasmic meningoencephalitis in an immunocompetent host
Rajeev M Kaushik1, Sukhdev K Mahajan, Anita Sharma
1Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Nagar, P.O. Doiwala 248140, Dehradun, Uttaranchal, India. rmkaushik1@rediffmail.com
Summary
Central nervous system toxoplasmosis is rare in immunocompetent individuals. This case highlights toxoplasmic meningoencephalitis mimicking tuberculosis, emphasizing the need for considering toxoplasmosis in non-responsive cases.
Area of Science:
- Infectious Diseases
- Neurology
- Immunology
Background:
- Central nervous system (CNS) toxoplasmosis is exceptionally uncommon in immunocompetent hosts.
- Toxoplasmic meningoencephalitis can present with symptoms mimicking other neurological infections, such as tuberculous meningoencephalitis.
Observation:
- A previously healthy, immunocompetent patient presented with clinical signs suggestive of tuberculous meningoencephalitis.
- The patient showed no improvement despite receiving standard antitubercular therapy.
- Brain magnetic resonance imaging (MRI) revealed findings supportive of CNS inflammation.
Findings:
- Serological testing confirmed the presence of toxoplasmosis.
- The patient demonstrated a significant clinical recovery following treatment with co-trimoxazole and prednisolone.
- These results definitively diagnosed toxoplasmic meningoencephalitis.
Implications:
- Toxoplasmosis should be included in the differential diagnosis for suspected tuberculous meningoencephalitis, particularly when patients do not respond to antitubercular treatment.
- Early consideration of toxoplasmosis can lead to timely and appropriate therapeutic interventions, improving patient outcomes.
- This case underscores the importance of comprehensive etiological investigations in complex neurological presentations.