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CASE REPORT
Year : 2022  |  Volume : 12  |  Issue : 6  |  Page : 283-286

Toxoplasma encephalitis – A presenting feature of HIV disease


Department of Medicine, Jawahar Lal Nehru Medical College, Ajmer, Rajasthan, India

Correspondence Address:
Dr. Ala Ram
Department of Medicine, Jawahar Lal Nehru Medical College, Ajmer, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmrp.cmrp_105_21

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Central nervous system (CNS) toxoplasmosis is one of the leading causes of secondary CNS infection and seizures in human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) patients along with cryptococcosis and tuberculosis. Encephalitis can be a primary presentation in undiagnosed HIV patients. We are reporting a rare case of HIV/AIDS that presented to us with encephalitis and was later diagnosed as toxoplasma encephalitis. A 32-year-old male truck driver presented with altered behaviour for about 1 month and vomiting for 4 days. On clinical examination, papilloedema was present. Further investigations revealed serologically proven HIV with CD4 T lymphocyte count of 56 cells/microL. Brain imaging showed multiple ring-enhancing lesions in the bilateral cerebral hemispheres and right cerebellar hemisphere. Serum toxoplasma antibodies were found to be positive and a diagnosis of CNS toxoplasmosis encephalitis was made. Treatment with trimethoprim–sulphamethoxazole and highly active antiretroviral therapy was initiated following which there was a significant improvement in the patient's clinical condition. The patient is on regular follow-up now.


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