A rare case of toxoplasmosis encephalomyelitis in a patient with HIV infection
https://doi.org/10.24884/1607-4181-2026-33-1-133-141
Abstract
CNS toxoplasmosis is a relatively frequent complication of HIV infection, most commonly involving brain lesions. However, there are only a few publications reporting cases of toxoplasmosis associated myelitis or encephalomyelitis. In this article, we present a rare clinical case of encephalomyelitis in a 53-year-old patient with newly diagnosed HIV infection in the stage of severe immunodeficiency. The patient additionally developed haematological side effects from specific anti toxoplasmosis therapy, which were successfully managed. Despite of the late initiation of etiotropic therapy, clinical, laboratory, and neuroimaging improvement was observed by the 51st day of specific treatment.
Supporting agencies: Artificial intelligence GPT-4 was used for paraphrasing and grammar verification. The authors inde-pendently checked all facts and are responsible for the content of the article.
About the Authors
A. V. Koloteva
Center for Prevention and Control of AIDS and Infectious Diseases; Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Koloteva Anna V., Neurologist, Center for Prevention and Control of AIDS and Infectious Diseases; Post-graduate Student of the Department of Neurology, Pavlov University
179, Obvodny Canal Embankment, Saint Petersburg, 198103
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Author declares no conflict of interest.
E. M. Bazyuk
Center for Prevention and Control of AIDS and Infectious Diseases; Smorodintsev Research Institute of Influenza
Russian Federation
Competing Interests:
Russian Federation
Evgenia M., Head of the 3rd Infectious Diseases Department, Center for Prevention and Control of AIDS and Infectious Diseases; Postgraduate Student, Smorodintsev Research Institute of Influenza
179, Obvodny Canal Embankment, Saint Petersburg, 198103
15/17, Prof. Popova str., Saint Petersburg, 197022
Competing Interests:
Author declares no conflict of interest.
N. V. Shuleshova
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Shuleshova Natalya V., Dr. of Sci. (Med.), Professor, Professor of the Department of Neurology
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Author declares no conflict of interest.
T. N. Vinogradova
Center for Prevention and Control of AIDS and Infectious Diseases
Russian Federation
Competing Interests:
Russian Federation
Vinogradova Tatiana N., Cand. of Sci. (Med.), Chief Physician, Center for Prevention and Control of AIDS and Infectious Diseases
179, Obvodny Canal Embankment, Saint Petersburg, 198103
Competing Interests:
Author declares no conflict of interest.
E. V. Stepanova
Center for Prevention and Control of AIDS and Infectious Diseases; Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Stepanova Elena V., Dr. of Sci. (Med.), Professor, Center for Prevention and Control of AIDS and Infectious Diseases; Professor, Pavlov University
179, Obvodny Canal Embankment, Saint Petersburg, 198103
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Author declares no conflict of interest.
References
1. Angel S. O., Vanagas L., Alonso A. M. Mechanisms of adaptation and evolution in Toxoplasma gondii // Mol Biochem Parasitol. 2024;258:111615. https://doi.org/10.1016/j.molbiopara.2024.111615.
2. Belyakov N. A., Rassokhin V. V., Azovtseva O. V. et al. Comorbid conditions in HIV infection. Part II. Saint Petersburg: Baltic Medical Educational Center; 2019. 252 p. ISBN 978-5-6041807-2-2. (In Russ.)
3. Ortiz O. R., Norris T. A. A blast from the past: toxoplasmic encephalitis as the initial presentation of HIV/AIDS // Cureus. 2024;16(4):e58693. https://doi.org/10.7759/cureus.58693.
4. London F., Mulquin N., Ossemann M. Longitudinally extensive spinal cord lesion: keep toxoplasmosis in mind // Acta Neurol Belg. 2023;123(1):323–325. https://doi.org/10.1007/s13760-023-02184-3.
5. Fairley C. K., Wodak J., Benson E. Spinal cord toxoplasmosis in a patient with human immunodeficiency virus infection // Int J STD AIDS. 1992;3(5):366–368. https://doi.org/10.1177/095646249200300514.
6. Gonzalez G. A., Porto G., Tecce E. et al. Advances in diagnosis and management of atypical spinal infections: a comprehensive review // North Am Spine Soc J. 2023;16:100282. https://doi.org/10.1016/j.xnsj.2023.100282.
7. García-García C., Castillo-Álvarez F., Azcona-Gutiérrez J. M. et al. Spinal cord toxoplasmosis in human immunodeficiency virus infection/acquired immunodeficiency syndrome // Infect Dis (Lond). 2015;47(5):277–282. https://doi.org/10.3109/00365548.2014.993421.
8. Sireesha Y., Uppin M. S., Bohra K. et al. Longitudinally extensive transverse myelitis due to Toxoplasma: an autopsy study // Ann Indian Acad Neurol. 2018;21(2):161. https://doi.org/10.4103/aian.aian_387_17.
9. Garcia-Gubern C., Fuentes C. R., Colon-Rolon L., Masvidal D. Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature // Int J Emerg Med. 2010;3(4):439–442. https://doi.org/10.1007/s12245-010-0207-7.
10. Liu J., Li D., Wang W. et al. Clinical and imaging characteristics of toxoplasmic encephalitis in patients with HIV/AIDS with different immune statuses // Quant Imaging Med Surg. 2025;15(8):7259–7268. https://doi.org/10.21037/qims-2024-2598. PMID: 40785890; PMCID: PMC12332595.
11. Vidal J. E. HIV-related cerebral toxoplasmosis revisited: current concepts and controversies of an old disease // J Int Assoc Providers AIDS Care. 2019;18:2325958219867315. https://doi.org/10.1177/2325958219867315.
12. Dian S., Ganiem A. R., Ekawardhani S. Cerebral toxoplasmosis in HIV-infected patients: a review // Pathog Glob Health. 2023;117(1):14–23. https://doi.org/10.1080/20477724.2022.2083977.
13. Bassa B., Hahner F., Meyding-Lamadé U. Erregerbedingte Erkrankungen des Rückenmarks und seiner angrenzenden Strukturen // Nervenarzt. 2024;95:948–956. https://doi.org/10.1007/s00115-024-01743-0.
14. Bartlett D., Redfield R., Fam P., Mazus A. I. eds. Clinical aspects of HIV infection. Moscow: GRANAT; 2013. 495–497 p. ISBN 978-5-906456-03-8.
15. Order of the Ministry of Health of Russia dated November 9, 2012, No. 758n. On approval of the standard for specialized medical care for HIV infection. (In Russ.).
16. Ministry of Health of the Russian Federation. Clinical guidelines “HIV infection in adults” [Electronic resource]. Moscow: Ministry of Health of Russia; 2024. p. 44–45. Available at: (accessed: 10.12.2025). (In Russ.).
17. Modern standards for analysis of radiological images and principles of report writing. Trofimova T. N., eds. Saint Petersburg: Baltic Medical Educational Center; 2nd ed. 384 p. (In Russ.). ISBN 978-5-6045822-3-7.
18. Mohole J., Ho A. L., Sussman E. S. et al. Focal intramedullary spinal cord lesion in human immunodeficiency virus/acquired immunodeficiency syndrome: toxoplasmosis versus lymphoma // World Neurosurg. 2019;127:227–231. https://doi.org/10.1016/j.wneu.2019.04.057.
19. Richie M. B., Pruitt A. A. Spinal cord infections // Neurol Clin. 2013;31(1):19–53. https://doi.org/10.1016/j.ncl.2012.09.006.
20. Möhle L., Parlog A., Pahnke J., Dunay I. R. Spinal cord pathology in chronic experimental Toxoplasma gondii infection // Eur J Microbiol Immunol. 2014;4(1):65. https://doi.org/10.1556/EUJMI.4.2014.1.6.
Review
For citations:
Koloteva A.V., Bazyuk E.M., Shuleshova N.V., Vinogradova T.N., Stepanova E.V. A rare case of toxoplasmosis encephalomyelitis in a patient with HIV infection. The Scientific Notes of the Pavlov University. 2026;33(1):133-141. (In Russ.) https://doi.org/10.24884/1607-4181-2026-33-1-133-141
Views:
73
JATS XML
Email this article 