[Spinal cord toxoplasmosis in HIV infection].
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.
Pittner
Y
Y
Service de maladies infectieuses, hôpital de la Croix-Rousse, 93, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France. yves.pittner@free.fr
Dufour
J-F
JF
David
G
G
Boibieux
A
A
Peyramond
D
D
D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000469:parasitology; D003937:Diagnosis, Differential; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D011859:Radiography; D012680:Sensitivity and Specificity; D013118:Spinal Cord Diseases / Q000469:parasitology / Q000473:pathology; D014122:Toxoplasma / Q000235:genetics / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology
D000981:Antiprotozoal Agents