Multicystic encephalomalacia complicating congenital toxoplasmosis. Reportof a case.

An infant born at 40 weeks gestational age after an uneventful pregnancy wa s found to have severe macrocrania at birth, Multicystic encephalomalacia w as diagnosed based on transfontanellar ultrasonography and magnetic resonan ce imaging findings. Serum levels of IgM, IgG, and IgA antibodies for Toxop lasma gondii were elevated in the neonate and his mother. Investigations fo r other causes were negative. Examination of a cerebrospinal fluid specimen showed albumin level elevation to 4 g/L. Neither chorioretinitis nor intra cerebral calcifications were found. There was no response to treatment with pyrimethamine-sulfadoxine and a systemic glucocorticoid. At last follow-up , the infant was seven months of age and had intractable epilepsy and profo und developmental retardation. With reference to this highly unusual case, the clinical and etiological aspects of multicystic encephalomalacia are re viewed.