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Congenital Toxoplasmosis With Atypical Neuroimaging: Hydrocephalus and Bilateral Chorioretinitis Without Intracranial Calcifications
Journal article   Open access   Peer reviewed

Congenital Toxoplasmosis With Atypical Neuroimaging: Hydrocephalus and Bilateral Chorioretinitis Without Intracranial Calcifications

Saubhagya Dhakal, Pradeep Raj Regmi, Prajwal Dhakal, Binaya Adhikari, Shashi Shekhar Shingh and Basanta Sharma Paudel
Case reports in radiology, Vol.2026(1), 3021918
01/01/2026
DOI: 10.1155/crra/3021918
PMCID: PMC13051784
PMID: 41947973
url
https://doi.org/10.1155/crra/3021918View
Published (Version of record) Open Access

Abstract

We report a rare case of congenital toxoplasmosis in a 2‐month‐old female infant from rural Nepal, born to a primigravida mother without prenatal care. The infant presented with progressive lethargy, feeding difficulties, intermittent fever, and progressive macrocephaly. Neuroimaging revealed obstructive hydrocephalus and multiple cerebral ring‐enhancing lesions without intracranial calcifications. Ophthalmologic examination demonstrated bilateral chorioretinitis. Serologic testing confirmed congenital toxoplasmosis. Despite initiation of standard therapy with pyrimethamine, sulfadiazine, and folinic acid, the infant experienced clinical deterioration prior to planned neurosurgical intervention. This case highlights the clinical and radiologic variability of congenital toxoplasmosis, the diagnostic challenges in resource‐limited settings, and the importance of recognizing atypical imaging patterns to guide timely management.
 Infants Medical Imaging Neuroimaging Serology Calcification Case reports Cytomegalovirus Hydrocephalus Infections Jaundice Lethargy Presentations Protozoa Rubella Sepsis Syphilis Toxoplasmosis Ultrasonic imaging

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