A 43-year-old male presented to the hospital with headaches and right facial twitching for a few days which was associated with nausea and dizziness. Medical history: Significant for infection with HIV; diagnosed 10 years before the onset of his current illness. Drug history: The patient had stopped his highly active antiretroviral therapy (HAART) 10 months earlier due to financial insufficiency.
Physical examination: The patient was observed to have a mild word-finding deficit, right pronator drift, mild right arm hyperreflexia, and right facial droop. Laboratory workup White blood cell count of 3400/mL CD4 count of 78/mL HIV viral load above 500,000/mL Positive Toxoplasma immunoglobulin G antibodies Negative serum cryptococcal antigen, nonreactive Rapid Plasma Reagin Test MRI showed a large mass in the left frontoparietal region along with small, non-enhancing lesions in the brain. A…
