| CASE REPORT |
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| Year : 2022 | Volume
: 12
| Issue : 6 | Page : 283-286 |
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Toxoplasma encephalitis – A presenting feature of HIV disease
Ala Ram, Pankaj Kumar Saini, Aakash Garg, Shakti Singh, Kavin Kumar, Sanjiv Maheshwari
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
 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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