A homosexual man with a history of sexually transmitted infections including recent giardiasis and high cytomegalovirus (CMV) titer was admitted with generalized weakness, headache, and depression. He rapidly became comatose and developed signs of increased intracranial pressure. CT scan revealed a right cerebral lesion. Pathologic examination disclosed an acute necrotizing granulomatous toxoplasmosis involving the cerebrum. This case represents an example of an opportunistic infection in a male homosexual associated with fulminant clinical course, probably on the basis of immune deficiency.
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