Neurotoxoplasmosis mimicking intracranial tuberculoma

Neurotoxoplasmosis is a major cause of morbidity and mortality, especially in immunocompromised patients. Definitive diagnosis is invasive and difficult thereby requiring a therapeutic trial. We herein report a case of an 11-year-old boy who presented with a tuberculoma on computerized tomography (CT) brain and did not show any clinical improvement on anti-tuberculous drugs. Subsequently, reviewing the CT scans and with supportive serology, a diagnosis of neurotoxoplasmosis was considered. A trial of antitoxoplasmosis therapy was given to which the child fully responded in two weeks. Three weeks later, his magnetic resonance imaging showed complete resolution of the lesion. This report provides an insight into the significance of therapeutic trial in neurotoxoplasmosis.