Cerebral Toxoplasmosis in an HIV-Negative Patient: A Case Report

Zahra Arab-Mazar, Mohammad Hossein Zamanian, Davood Yadegarynia



Introduction: Toxoplasmosis is caused by infection with the obligate intracellular parasite Toxoplasma gondii. Toxoplasmosis is generally a late complication of HIV infection and usually occurs in patients with CD4+ T-cell counts below 200 cells/ìL.
Case Presentation: A case of cerebral toxoplasmosis is reported in a healthy 39-year-old woman who was admitted to hospital with the complaint of a headache. Gadolinium-enhanced brain magnetic resonance imaging (MRI) showed an irregular, ring enhancing, hyperintense lesion in the right temporoparietal lobe. Toxoplasma serology revealed raised IgG antibody levels. Based on the MRI features, biopsy, and serology, a diagnosis of cerebral toxoplasmosis was made.
Conclusions: Cerebral toxoplasmosis can occur outside the setting of advanced HIV immunodeficiency or drug-induced immunosuppression. This highlights the fact that it should be considered in the differential diagnosis of opportunistic infections in HIV-negative patients.


Cerebral Toxoplasmosis, Non-HIV Patient, Headache

Full Text:




Harker KS, Ueno N, Lodoen MB. Toxoplasma gondii dissemination:

a parasite's journey through the infected host. Parasite Immunol.

;37(3):141–9. doi: 10.1111/pim.12163. [PubMed: 25408224]

Ganiem AR, Dian S, Indriati A, Chaidir L, Wisaksana R, Sturm P,

et al. Cerebral toxoplasmosis mimicking subacute meningitis

in HIV-infected patients; a cohort study from Indonesia. PLoS

Negl Trop Dis. 2013;7(1):e1994. doi: 10.1371/journal.pntd.0001994.

[PubMed: 23326616]

Robert-Gangneux F, Darde ML. Epidemiology of and diagnostic

strategies for toxoplasmosis. Clin Microbiol Rev. 2012;25(2):264–

doi: 10.1128/CMR.05013-11. [PubMed: 22491772]

Nissapatorn V, Lee C, Quek KF, Leong CL, Mahmud R, Abdullah

KA. Toxoplasmosis in HIV/AIDS patients: a current situation. Jpn J

Infect Dis. 2004;57(4):160–5. [PubMed: 15329448]

Sarkari B, Abdolahi Khabisi S. Severe congenital toxoplasmosis:

a case report and strain characterization. Case Rep Infect Dis.

;2015:851085. doi: 10.1155/2015/851085. [PubMed: 25685568]

Goswami RP, Goswami RP, Rahman M, Ray Y, Tripathi SK. Alternative

treatment approach to cerebral toxoplasmosis in HIV/

AIDS: experience from a resource-poor setting. Int J STD AIDS.

;26(12):864–9. doi: 10.1177/0956462414560594. [PubMed:

Madi D, Achappa B, Rao S, Ramapuram JT, Mahalingam S. Successful

treatment of cerebral toxoplasmosis with clindamycin: a case

report. Oman Med J. 2012;27(5):411–2. doi: 10.5001/omj.2012.100.

[PubMed: 23074553]

Prandota J, Gryglas A, Fuglewicz A, Zeslawska-Falenczyk A, Ujma-

Czapska B, Szenborn L, et al. Recurrent headaches may be caused

by cerebral toxoplasmosis. World J Clin Pediatr. 2014;3(3):59–68.

doi: 10.5409/wjcp.v3.i3.59. [PubMed: 25254186]

Fearon P, Hotopf M. Relation between headache in childhood

and physical and psychiatric symptoms in adulthood: national

birth cohort study. BMJ. 2001;322(7295):1145. [PubMed: 11348907]

Kim HW, Won KS, Choi BW, Zeon SK. Cerebral Toxoplasmosis

in a Patient with AIDS on F-18 FDG PET/CT. Nucl Med Mol Imaging.

;44(1):75–7. doi: 10.1007/s13139-009-0014-3. [PubMed: