Spinal cord toxoplasmosis in human immunodeficiency virus infection/acquired immunodeficiency syndrome

Abstract

Neurological complications in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) are still common, even in the era of highly active antiretroviral therapy. Opportunistic infections, immune reconstitution, the virus itself, antiretroviral drugs and neurocognitive disorders have to be considered when establishing the differential diagnosis. Toxoplasmic encephalitis remains the major cause of space-occupying lesions in the brain of patients with HIV/AIDS; however, spinal cord involvement has been reported infrequently. Here, we review spinal cord toxoplasmosis in HIV infection and illustrate the condition with a recent case from our hospital. We suggest that most patients with HIV/AIDS and myelitis with enhanced spine lesions, multiple brain lesions and positive serology for Toxoplasma gondii should receive immediate empirical treatment for toxoplasmosis, and a biopsy should be performed in those cases without clinical improvement or with deterioration.

Keywords::

• AIDS
• HIV
• myelitis
• spinal cord disease
• toxoplasmosis

Acknowledgement

We thank Rita Moreira da Silva for checking the manuscript for proper English usage.

Declaration of interest: The authors declare that there is no conflict of interest. The study received no funding.