Case Report: Cotrimoxazole in the Treatment of a Midbrain Toxoplasmosis in HIV Patient

Abstract

This is a case of cerebral toxoplasmosis presenting at the time of diagnosis of HIV. Cerebral toxoplasmosis is one of the most common intracranial opportunistic diseases occuring in HIV, presenting with mass lesions. A 52 year-old woman who presented to Olabisi Onabanjo University Teaching Hospital (OOUTH) with features of headache, visual blurring, drooling of eyelids, vomiting and progressive difficulty walking. She was sero-positive for HIVwhen tested in the course of the illness and she is HAART-naive. Brain MRI done showed multiple ring-enhancing lesions with mass effects consistent with cerebral toxoplasmosis with the involvement of the midbrain. She was treated with cotrimoxazole, HAART and medical decompression therapy. She made significant improvement and was discharged 3 weeks after. Six month post treatment parameters showed resolution of lesions on the MRI and rise of CD4 count from 24 to 240cells/mm.