A 48-year-old male patient:
* HIV (+)
* Presented to emergency with headache, confusion, N/V



What do you see?






Small corticomedullary hyperintense lesions (a-c) with faint enhancement (d-e)


Toxoplasmosis
* Most common opportunistic CNS infection and most common cause of a mass lesion in AIDS
* Basal ganglia, thalamus, corticomedullary junction and cerebellum frequently involved
* Microhemorrhages can be seen on SWI; lesions may have ring or nodular enhancement
* Major ddx is lymphoma
– Lymphoma is usually solitary, whereas solitary lesions are uncommon in toxoplasmosis
– Microhemorrhages are uncommon in lymphoma
Shouldn’t we include fungal and TB infection in the differential list also? Due to hemorrhagic component, nodular and ring enhancing lesion?
In description right and left side changed.