Cytotoxic Lesions of the Corpus Callosum in Typhoid Infection: A Case Report

Abstract

Background: Cytotoxic lesions of the corpus callosum (CLOCCs) are increasingly recognised as reversible neuroradiological abnormalities associated with diverse infectious and inflammatory conditions. However, their occurrence in bacterial infections, particularly typhoid fever, remains exceedingly uncommon and poorly documented in the literature. Aim: To report a rare case of cytotoxic lesions of the corpus callosum (CLOCCs) associated with typhoid infection and to highlight its reversible radiological nature in infectious encephalopathies. Presentation of Case: Cytotoxic lesions of the corpus callosum (CLOCCs) are transient MRI abnormalities, most commonly involving the splenium of the corpus callosum, and are associated with infections, seizures, metabolic disturbances, drug toxicity, and autoimmune disorders. Viral infections are the most frequently reported infectious causes. Proposed mechanisms include cytokine-mediated cytotoxic edema and reversible inflammatory injury affecting densely myelinated splenial fibers. Clinically, patients may present with altered sensorium, delirium, encephalopathy, or seizures, often posing a diagnostic challenge. We report a rare case of CLOCCs occurring in a patient with typhoid encephalitis. Discussion: Typhoid fever caused by Salmonella typhi commonly presents with systemic manifestations, whereas neurological involvement such as encephalopathy is uncommon. The occurrence of CLOCCs in typhoid encephalitis is exceedingly rare and sparsely described in literature. Recognition of this characteristic MRI pattern is important to avoid unnecessary invasive investigations and to support timely diagnosis of the underlying infectious etiology. Conclusion: CLOCCs should be considered in patients with acute febrile encephalopathy and reversible splenial lesions on MRI. Early recognition and appropriate treatment of the underlying infection are associated with favorable neurological and radiological recovery.