Spinal Cord Involvement and Brain Hemorrhage as an Atypical Presentation of Toxoplasmosis in a Patient with HIV

Central nervous system (CNS) toxoplasmosis is a well-known opportunistic infection in patients with AIDS. Spinal cord involvement and brain hemorrhage are very infrequent manifestations of CNS toxoplasmosis. In this report, we describe patient unknown AIDS presenting bilateral headaches new onset leg weakness, diagnosed CSF polymerase chain reaction (PCR) for T. gondii, associated spinal (a central lesion the conus medullaris) multiple lesions hemorrhage. The required therapy pyrimethamine, sulfadiazine, dexamethasone, favorable outcomes after 30 days therapy. Our case re-emphasizes diagnosis advance HIV disease involvement. A high index suspicion needed, especially HIV/AIDS not receiving HAART, who seropositive have CD4+ count less than 100 cells/mm3, present symptoms consistent even more suggestive coincident lesions.