Congenital toxoplasmosis presenting as central diabetes insipidus in an infant: a case report.

[congenital toxoplasmosis]

Congenital toxoplasmosis has a wide range of presentation at birth varying from severe neurological features such as hydrocephalus and chorioretinitis to a well appearing baby , who may develop complications late in infancy . While neuroendocrine abnormalities associated with congenital toxoplasmosis are uncommon , isolated central diabetes insipidus is extremely rare .Here , we report on a female infant who presented with fever , convulsions , and polyuria . Examination revealed weight and length below the 3rd centile along with signs of severe dehydration . Fundal examination showed bilateral chorioretinitis . This infant developed hypernatremia together with increased serum osmolality and decreased both urine osmolality and specific gravity consistent with central diabetes insipidus . Serology for toxoplasma specific immunoglobulin M was high for both the mother and the baby and polymerase chain reaction for toxoplasma deoxyribonucleic acid was positive in the infant confirming congenital toxoplasmosis . Brain computerized tomography scans demonstrated ventriculomegaly associated with cerebral and cortical calcifications . Fluid and electrolyte abnormalities responded to nasal vasopressin therapy .This report highlights central diabetes inspidus as a rare presentation of congenital toxoplasmosis .