Central vestibular vertigo due to cerebellar lesions caused by cerebral toxoplasmosis in HIV/AIDS patient: A case report

Background. Cerebral toxoplasmosis is a serious opportunistic infection in patients with HIV/AIDS that can lead to various neurological complications, including central vestibular vertigo. This report presents a rare case of cerebellar involvement manifesting primarily as vertigo. Case report. A 45-year-old male with HIV/AIDS presented with persistent vertigo, diplopia, and significant weight loss. Brain MRI revealed multiple ring-enhancing lesions in the cerebellum, suggestive of cerebral toxoplasmosis. Serological testing was positive for both anti-HIV and anti-Toxoplasma IgG antibodies, and his CD4 count was 195 cells/μL. The patient was treated with cotrimoxazole, corticosteroids, and supportive therapy, resulting in clinical improvement. Conclusions. This case highlights the importance of considering cerebral toxoplasmosis in HIV/AIDS patients who present with central vestibular vertigo and cerebellar signs. Early diagnosis through neuroimaging and serological testing is essential for timely treatment. Prompt initiation of antimicrobial therapy and supportive care can lead to favorable clinical outcomes, underscoring the need for vigilance in similar clinical scenarios.