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Case Reports
. 2015 Sep;15(3):1045-8.
doi: 10.4314/ahs.v15i3.47.

Multiple intracerebral lesions in a young male

Madi Deepak  1 , Achappa Basavaprabhu  1 , Mahalingam Soundarya  2
Affiliations
Case Reports

Multiple intracerebral lesions in a young male

Madi Deepak et al. Afr Health Sci. 2015 Sep.

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; Neurocysticercosis; Tuberculoma.

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Figures

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Coronal T1 weighted post contrast image showing supratentorial and infratentorial ring enhancing and nodular enhancing lesions on both sides.
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Repeat MRI of brain after 2 weeks showing significant resolution of the lesions.
See this image and copyright information in PMC

References

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