Sireesha Yareeda, Uppin Megha S, Bohra Komal, Alugolu Rajesh, Neeharika Mathukumalli L, Kanikannan Angamuthu
Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Ann Indian Acad Neurol. 2018 Apr-Jun;21(2):161-163. doi: 10.4103/aian.AIAN_387_17.
Toxoplasma is an obligate intracellular parasite that remains asymptomatic in humans but, at times, can cause devastating disease. Here, we describe an autopsy study of a young immunocompetent gentleman with no comorbidities whose presentation was acute transverse myelitis. Magnetic resonance imaging spine showed longitudinally extensive spinal cord lesion (LESCL) that mimicked neuromyelitis optica with normal brain imaging at presentation. Investigations showed albuminocytological dissociation which prompted a course of parenteral steroid. However, the lesion relentlessly progressed to involve the brain stem and cerebrum leading to toxoplasmic encephalitis that terminated fatally. This report highlights that toxoplasma can present as LESCL and needs to be considered in the differential diagnosis of atypical myelitis.
弓形虫是一种专性细胞内寄生虫，在人类中通常无症状，但有时可引发严重疾病。在此，我们描述了一项对一名无合并症的年轻免疫功能正常男性的尸检研究，其临床表现为急性横贯性脊髓炎。脊柱磁共振成像显示纵向广泛脊髓病变（LESCL），在发病时类似视神经脊髓炎且脑部成像正常。检查显示蛋白细胞分离，这促使采用了肠外类固醇治疗方案。然而，病变持续进展，累及脑干和大脑，导致致命的弓形虫性脑炎。本报告强调，弓形虫可表现为LESCL，在非典型脊髓炎的鉴别诊断中需要考虑到这一点。
