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Case 3: A 36-Year-Old with Headache, Fever, and a Seizure

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D Based on the clinical and radiographic findings, the most likely diagnosis is Toxoplasma encephalitis. Empiric therapy with pyrimethamine (Daraprim) plus sulfadiazine plus leucovorin should be started.

This answer is correct. Toxoplasma encephalitis is the most likely diagnosis considering the patient’s clinical history, CD4 cell count, positive Toxoplasma antibody status, discontinuation of Toxoplasma prophylaxis, and presence of multiple ring-enhancing lesions on CT scan. The initial approach to patients with suspected Toxoplasma encephalitis is to start empiric treatment with pyrimethamine (Daraprim) plus sulfadiazine and leucovorin. Patients generally show clinical and radiographic improvement within 14 days.

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