Clinico-radiological assessment of a rare case of immunocompetent patient with cerebral toxoplasmosis

Toxoplasmosis is a serious and potentially fatal disease in humans with a high prevalence in immunocompromised individuals. The disease has a wide spectrum of presentations, depending on the immune status of the person. Neurotoxoplasmosis in an immunocompetent person is rare and often unnoticed. In this case, we presented a 75-year-old man who had rapid-onset left hemiparesis, left focal fits, and right-sided multifocal space-occupying lesions, which were characterized by basal ganglia involvement and hemorrhagic content on radiological investigations. His imaging was suggestive of an inflammatory process rather than a neoplastic disorder with positive toxoplasma serology. The possibility of toxoplasmosis was considered. The patient was put on antitoxoplasma therapy (intravenous clindamycin 600 mg amp IV every 6 h). A marked clinical improvement was observed within two weeks. A follow-up magnetic resonance imaging (MRI) after 2 and 6 weeks showed regression of the lesions.