Case Reports

Hemichorea-Hemiballismus as a Presentation of Cerebritis from Intracranial Toxoplasmosis and Tuberculosis

Authors:

Abstract

Background: There is limited literature documenting hemichorea-hemiballism (HCHB) resulting from co-infection of toxoplasmosis and tuberculosis (TB) in acquired immunodeficiency syndrome (AIDS). Toxoplasmic abscess is the most common cause while TB is a rare etiology.

Case Description: We describe a 24-year-old male with AIDS-related HCHB as the presentation of cerebritis on the right subthalamic nucleus and cerebral peduncle from intracranial toxoplasma and TB co-infection. Antimicrobials and symptomatic therapy were given. Marked improvement was seen on follow-up.

Discussion: HCHB may be the initial presentation of intracranial involvement of this coinfection in the setting of AIDS and is potentially reversible with timely management.

Highlights:

  • Hemichorea-hemiballismus (HCHB) may be an initial presentation of intracranial involvement of concomitant toxoplasmosis and tuberculosis causing focal cerebritis in the contralateral subthalamic nucleus and cerebral peduncle, particularly in the setting of human immunodeficiency virus infection.
  • Acquired immunodeficiency syndrome-related HCHB is potentially reversible with timely diagnosis and treatment.

 

Keywords:

hemichoreahemiballismustoxoplasmosiscerebritisintracranial tuberculosis
  • Year: 2021
  • Volume: 11
  • Page/Article: 2
  • DOI: 10.5334/tohm.576
  • Submitted on 18 Oct 2020
  • Accepted on 12 Dec 2020
  • Published on 20 Jan 2021
  • Peer Reviewed