We report the case of an atypical localization of a spinal cord ‘toxoplasmic abscess’. The 46-year-old patient, HIV-1 positive, was admitted for acute urine retention and gait disorders. MRI revealed a T12-L1 medullary lesion suggesting a tumoral, inflammatory and infectious pathology. The radiological aspect and immunosuppression lead to the initiation of a treatment against Toxoplasma gondii, following the same treatment principles as for cerebral toxoplasmosis. The diagnosis can only be proved by data from autopsy or surgical biopsy, but toxoplasmosis PCR on CSF seems to be an interesting alternative to confirm the diagnosis. According to the literature, PCR is not sensitive enough as a diagnostic tool. Improvement after treatment supported the diagnosis confirmed by PCR
Keywords : Animals,Antiprotozoal Agents,Autopsy,Biopsy,cerebrospinal fluid,complications,diagnosis,Diagnosis,Differential,diagnostic imaging,drug therapy,France,Gait,genetics,HIV Infections,Humans,Immunosuppression,isolation & purification,Magnetic Resonance Imaging,Male,methods,Middle Aged,parasitology,pathology,Polymerase Chain Reaction,Radiography,Sensitivity and Specificity,Spinal Cord,Spinal Cord Diseases,therapeutic use,Toxoplasma,Toxoplasmosis,, Cord,Toxoplasmosis,Hiv,Infection, genitofemoral neuralgia male
Date of Publication : 2009 Jun
Authors : Pittner Y;Dufour JF;David G;Boibieux A;Peyramond D;
Organisation : Service de maladies infectieuses, hopital de la Croix-Rousse, 93, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France. yves.pittner@free.fr
Journal of Publication : Med Mal Infect
Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/19304424
The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery
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