Cerebral Toxoplasmosis in an Immunocompetent Individual Presenting as a Solitary Space-Occupying Lesion: A Case Report

Abstract

We report a case of an apparently healthy, immunocompetent individual who presented with headache and symptoms suggestive of raised intracranial pressure. Neurological imaging revealed marked edema in the basal ganglia. His history was remarkable for sustained contact with domestic felines. He was started on trimethoprim-sulphamethoxazole based on history, strongly positive serology, and radiological findings. He showed a marked response to treatment. The characteristic radiological findings, serology, and dramatic response to treatment confirmed the diagnosis in this case. A tissue diagnosis was not required in our case. This case highlights that immunocompetent individuals can develop neurological manifestations. Though cerebral toxoplasmosis is classically associated with multiple lesions, our case highlights that presentation as a solitary space-occupying lesion is also possible. Further research is needed to ascertain if prolonged exposure or extensive exposure is associated with severe manifestations.