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African Health Sciences
Makerere University Medical School
ISSN: 1680-6905 EISSN: 1680-6905
Vol. 15, No. 3, 2015, pp. 1045-1048
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Bioline Code: hs15144
Full paper language: English
Document type: Case Report
Document available free of charge
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African Health Sciences, Vol. 15, No. 3, 2015, pp. 1045-1048
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Multiple intracerebral lesions in a young male
Deepak, Madi; Basavaprabhu, Achappa & Soundarya, Mahalingam
Abstract
Background: As the incidence of HIV infection has increased its neurological complications are being encountered in our
clinical practice. Toxoplasmosis is a common cerebral opportunistic infection seen in HIV-infected patients, even though the
incidence has declined with the use of antiretroviral therapy. Establishing a definitive diagnosis of cerebral toxoplasmosis is
difficult in resource limited settings.
Clinical case: A 20 year old gentleman was referred to our institute as a case of stroke. Magnetic resonance imaging (MRI)
of his brain showed multiple ill-defined and nodular enhancing lesions in bilateral supratentorial and infratentorial neuroparenchyma.
Test for HIV-1 was reactive. Toxoplasma serology revealed raised IgG antibody levels. Based on the MRI features
and positive toxoplasma serology a diagnosis of cerebral toxoplasmosis was made. He was treated with trimethoprim/
sulfamethoxazole and pyrimethamine/ Sulfadoxine for 3 weeks. After 2 weeks of treatment, repeat MRI of brain was done
which showed significant resolution of the lesions.
Conclusion: We are presenting this case to highlight the fact that cerebral toxoplasmosis should be considered in the differential
diagnosis of multiple neuroparenchymal lesions in young individuals who present with neurological deficits.
Keywords
Cerebral toxoplasmosis, HIV/AIDS, Tuberculoma, Neurocysticercosis
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