title: Acquired toxoplasmosis accompanied by facial nerve palsy in an immunocompetent 5-year-old child.
abstract: Acquired toxoplasmosis, although relatively common in children, is usually asymptomatic but can also be clinically manifested by a benign and self-limited infectious mononucleosis-like syndrome. Neurological complications are very rare in immunocompetent children. The authors report a 5-year-old boy who presented with cervical lymphadenopathy because of acquired toxoplasmosis accompanied with unilateral facial nerve paralysis. Toxoplasma gondii DNA detection in blood by polymerase chain reaction, as well as elevated specific immunoglobulin M antibodies against it, established the diagnosis. Characteristic brain lesions on magnetic resonance imaging were absent and ophthalmologic examination revealed no inflammatory lesions in the retina and choroid. Treatment with pyrimethamine, sulfadiazine, and folic acid resulted in a complete recovery after 2 months of therapy. Although rare, acute facial nerve paralysis of unknown origin can be caused by acquired toxoplasmosis even in the immunocompetent pediatric population. Elevated titers of specific antibodies and the presence of parasite's DNA are key findings for the correct diagnosis.
authors.affiliation: Department of Pediatrics, Medical School, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece. galtsin@otenet.gr
authors.forename: Assimina
authors.initials: A
authors.lastname: Galli-Tsinopoulou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kyrgios
authors.forename: Eleni Z
authors.initials: EZ
authors.lastname: Giannopoulou
authors.forename: Styliani
authors.initials: S
authors.lastname: Gourgoulia
authors.forename: Ioanna
authors.initials: I
authors.lastname: Maggana
authors.forename: Elina
authors.initials: E
authors.lastname: Katechaki
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Chatzidimitriou
authors.forename: Athanasios E
authors.initials: AE
authors.lastname: Evangeliou
mesh_terms: D000818:Animals; D002675:Child, Preschool; D005154:Facial Nerve / Q000276:immunology / Q000469:parasitology*; D005155:Facial Nerve Diseases / Q000175:diagnosis / Q000276:immunology / Q000469:parasitology*; D006801:Humans; D008297:Male; D014123:Toxoplasmosis / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D016896:Treatment Outcome