| CASE REPORT |
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| Year : 2014 | Volume
: 6
| Issue : 10 | Page : 545-548 |
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Acute confusional state: A manifestation of toxoplasma and CMV co-infection in HIV patient
Waqas Jehangir1, Romil Sareen2, Shuvendu Sen1, Nazar Raoof1, Abdalla Yousif1
1 Department of Internal Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, USA
2 Ross University School of Medicine, Portsmouth, Dominica, USA
Correspondence Address:
Waqas Jehangir
530 New Brunswick Ave, Perth Amboy, New Jersey-08861
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1947-2714.143290
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Context: When dealing with a patient with HIV that presents with an altered mental status, there are various infections and disease etiologies a physician has to rule out that may play a role in complicating the inherent complex nature of HIV. Toxoplasma gondii (T. gondii) and cytomegalovirus (CMV) affect a large part of the world's population and lead to a varied and broad symptomatology depending upon the severity of HIV, the CD4 count and how early the infection is diagnosed. Case Report: We report an HIV+ patient in his early 50s and with a low CD4 count that presented with severe lethargy and confusion. Imaging studies that were performed after stabilizing the patient revealed a ring-enhancing lesion in the brain and after further testing, a diagnosis of reactivated T. gondii with co-infection with CMV was made. Patients infected with T.gondii that are already immune-compromised deteriorate rapidly and the disease diagnosis poses several challenges. Conclusion: Clinicians have to be extremely careful about making a prompt diagnosis and initiate treatment without delay before the infection takes a deadly toll on the patient. Since our patient was not on the required prophylactic medication to prevent infection with T. gondii, it was imperative to start treatment in a timely manner and to monitor the patient for any further decline in functioning. |
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