Subject(s)
Bone Diseases, Metabolic/parasitology , Bone Diseases, Metabolic/surgery , Dermoscopy/methods , Laser Therapy/methods , Ossification, Heterotopic/parasitology , Ossification, Heterotopic/surgery , Skin Diseases, Genetic/parasitology , Skin Diseases, Genetic/surgery , Adult , Biopsy, Needle , Bone Diseases, Metabolic/diagnosis , Forehead/pathology , Humans , Immunohistochemistry , Italy , Male , Ossification, Heterotopic/diagnosis , Rare Diseases , Severity of Illness Index , Skin Diseases, Genetic/diagnosis , Treatment OutcomeABSTRACT
STUDY DESIGN: An extremely rare presentation of an isolated spinal toxoplasmic arachnoiditis is described. OBJECTIVE: To draw attention to the fact that spinal arachnoid membranes may be a potential reservoir for Toxoplasma gondii. SUMMARY OF BACKGROUND DATA: Central nervous system toxoplasmosis is a common manifestation in patients who are immunodeficient. Reports on the spinal toxoplasmosis are rare and focused on spinal cord involvement. METHODS: An adult patient presented with symptoms of spastic paraparesis that had begun 13 years before admission. Thoracic spinal magnetic resonance imaging showed small lesions in posterior subarachnoid space at Th7-Th8. A Th7-Th8 laminectomy was performed. Intradural-extramedullary lesions were excised. RESULTS: Clinical, immunologic, and pathologic examinations showed adhesive spinal arachnoiditis associated with osteoid formation caused by past toxoplasmic infection. There was no impairment of the immunologic defense system. CONCLUSION: Where no causative factor is found in serious spinal adhesive arachnoiditis, the possibility of spinal toxoplasmosis should also be investigated.
