Congenital cerebral toxoplasmosis

Case contributed by Alberto Martínez Calvo


Headaches. Sleep and behavior disorders.

Patient Data

Age: 8 years
Gender: Female

Multiple scattered bilateral cerebral calcifications, predominantly in corticomedullary junction.

Case Discussion

Additional findings and history was available: congenital intumescent cataract, microphthalmos, microcornea and chorioretinitis in the right eye. Documented history of toxoplasmosis in pregnancy.


Congenital toxoplasmosis is the second most common congenital infection, caused by intrauterine infection with the protozoan parasite Toxoplasma gondii that is found worldwide.

The presence of chorioretinitis, intracranial calcifications, and hydrocephalus is considered the classic triad of congenital toxoplasmosis. Fever, hydrocephalus or microcephaly, hepatosplenomegaly, jaundice, convulsions, chorioretinitis (often bilateral), cerebral calcifications, and abnormal cerebrospinal fluid are the classic features of severe congenital toxoplasmosis.

Imaging features of congenital toxoplasmosis resemble those of CMV, Zika, and LCMV.

NECT scans show extensive parenchymal calcifications that often appear "scattered" throughout the brain parenchyma.

In this case, the history of toxoplasmosis in pregnancy is the diagnostic key.

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