Spinal toxoplasmic arachnoiditis associated with osteoid formation - A rare presentation of toxoplasmosis

Study Design. An extremely rare presentation of an isolated spinal toxoplas mic arachnoiditis is described. Objective. To draw attention to the fact that spinal arachnoid membranes ma y be a potential reservoir for Toxoplasma gondii. Summary of Background Data. Central nervous system toxoplasmosis is a commo n 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 th at 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 e xcised. Results. Clinical, immunologic, and pathologic examinations showed adhesive spinal arachnoiditis associated with osteoid formation caused by past toxo plasmic infection. There was no impairment of the immunologic defense syste m. Conclusion. Where no causative factor is found in serious spinal adhesive a rachnoiditis, the possibility of spinal toxoplasmosis should also be invest igated.