A rare case of an HIV-seronegative patient with Toxoplasma gondii meningoencephalitis

Cerebral toxoplasmosis is a common opportunistic infection that causes expansive brain lesions in people living with HIV/AIDS. But it is extremely rarely associated with HIV negative patients. This study presents a case of a 23-year-old male with non HIV-relative cerebral toxoplasmosis. There was an acute onset of the disease. The first symptoms included fever and signs of meningoradicular irritation. Neurological abnormalities progressed in cranial nerves disorders and pyramidal syndrome. The cerebrospinal fluid (CSF) changes were consistent with those of viral meningoencephalitis. CT and MRI showed multiple ring-enhancing lesions with high-intensity signals in cerebrum brain stem and cerebellum. The tests for HIV (ELISA and Western blot) were negative. Serological detection of Toxoplasma gondii (T. gondii) IgM and IgG antibodies in the CSF confirmed the diagnosis. Parasitic, bacterial, viral encephalitis and meningoencephalitis, as well as neoplastic metastatic process and other neurological diseases were discussed in the differential diagnosis. The intensity of the disease activity fluctuated during the hospital stay regardless of the adequate therapy.