Article Sidebar
Article Details
Issue
Section
Articles
Main Article Content
Cerebellar Toxoplasmosis in HIV/AIDS: A Case Report
Abstract
BACKGROUND: Toxoplasma encephalitis is a common
presentation of Toxoplasma gondii infection of the central
nervous system in the late stage of human immunodeficiency
viral (HIV) infection. The definitive diagnosis requires
demonstration of toxoplasma in brain tissue. However, neuroradiologic
demonstration (using Computed Tomography or
Magnetic Resonance Imaging) of ring-enhanced multiple or
single focal intracranial lesions in the presence of
immunosuppression and prompt response to presumptive
therapy are diagnostic in the absence of histological facilities.
The rarity of toxoplasma lesions in the cerebellum prompts a
high index of clinical suspicion and early institution of
presumptive therapy in poor resource sub-Saharan countries
like Nigeria.
OBJECTIVE: To illustrate the presentation of recurrent
cerebellar toxoplasmosis in a patient with HIV/AIDS.
METHODS: A 34-year-old previously diagnosed HIV/AIDS
male patient with right-sided cerebellar signs on neurological
evaluation and a ring-enhancing lesion in the right cerebellar
hemisphere on CT brain scan. An initial response to antitoxoplasmic
drugs was short-lived due to poor compliance
resulting in recurrence of lesion.
RESULTS: On initial evaluation a diagnosis of cerebellar space
occupying lesion in a patient with HIV/AIDS was made. He
responded to treatment with clindamycin, pyremethamine and
pyridoxine. Following default in treatment for three months
he represented with florid cerebellar features, but again
responded rapidly to treatment.
CONCLUSION: Cerebellar toxoplasmosis is an infrequent
complication of HIV/AIDS. Early diagnosis with neuro-imaging
techniques and prompt institution of appropriate therapy
results in remarkable improvement. WAJM 2010; 29(2): 123-
126.
presentation of Toxoplasma gondii infection of the central
nervous system in the late stage of human immunodeficiency
viral (HIV) infection. The definitive diagnosis requires
demonstration of toxoplasma in brain tissue. However, neuroradiologic
demonstration (using Computed Tomography or
Magnetic Resonance Imaging) of ring-enhanced multiple or
single focal intracranial lesions in the presence of
immunosuppression and prompt response to presumptive
therapy are diagnostic in the absence of histological facilities.
The rarity of toxoplasma lesions in the cerebellum prompts a
high index of clinical suspicion and early institution of
presumptive therapy in poor resource sub-Saharan countries
like Nigeria.
OBJECTIVE: To illustrate the presentation of recurrent
cerebellar toxoplasmosis in a patient with HIV/AIDS.
METHODS: A 34-year-old previously diagnosed HIV/AIDS
male patient with right-sided cerebellar signs on neurological
evaluation and a ring-enhancing lesion in the right cerebellar
hemisphere on CT brain scan. An initial response to antitoxoplasmic
drugs was short-lived due to poor compliance
resulting in recurrence of lesion.
RESULTS: On initial evaluation a diagnosis of cerebellar space
occupying lesion in a patient with HIV/AIDS was made. He
responded to treatment with clindamycin, pyremethamine and
pyridoxine. Following default in treatment for three months
he represented with florid cerebellar features, but again
responded rapidly to treatment.
CONCLUSION: Cerebellar toxoplasmosis is an infrequent
complication of HIV/AIDS. Early diagnosis with neuro-imaging
techniques and prompt institution of appropriate therapy
results in remarkable improvement. WAJM 2010; 29(2): 123-
126.
