Open AccessLongitudinally extensive transverse myelitis due to toxoplasma: An autopsy study
Author(s) -
Sireesha Yareeda,
Megha S Uppin,
Komal Bohra,
Rajesh Alugolu,
Mathukumalli L Neeharika,
Angamuthu Kanikannan
Publication year - 2018
Publication title -
annals of indian academy of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.427
H-Index - 31
eISSN - 1998-3549
pISSN - 0972-2327
DOI - 10.4103/aian.aian_387_17
Subject(s) - medicine , transverse myelitis , neuromyelitis optica , autopsy , asymptomatic , lesion , pathology , myelitis , magnetic resonance imaging , differential diagnosis , spinal cord , encephalitis , radiology , multiple sclerosis , immunology , psychiatry , virus
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.