A 10 month old infant with nystagmus and strabismus

Attary S Jedari1, Z Maliky, Kh Daneshjou

  • 1Department of Pediatrics, Imam Khomeini Hospital, Tehran University of Medical Science, Tehran, Iran.

Insights

Congenital toxoplasmosis can manifest solely as nystagmus and strabismus in infants. Early diagnosis is crucial, as this parasitic infection may present with subtle ocular findings and brain calcifications.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Infectious Diseases

Background:

  • Congenital toxoplasmosis is a significant cause of visual impairment in children.
  • Early detection and treatment are vital to prevent long-term complications.

Observation:

  • A 10-month-old infant presented with nystagmus and strabismus following a five-month history of fever.
  • Ophthalmoscopy revealed characteristic salt-and-pepper retinopathy and scars.
  • Brain CT scan demonstrated multiple intracranial calcifications.

Findings:

  • Diagnosis was confirmed by a high titer of serum anti-Toxoplasma antibodies (IgG > 400).
  • The clinical presentation highlighted the potential for toxoplasmosis to cause isolated ocular abnormalities.

Implications:

  • This case underscores the importance of considering congenital toxoplasmosis in the differential diagnosis of abnormal infant eye movements.
  • Prompt recognition can lead to timely intervention, potentially mitigating severe visual and neurological sequelae.