Progressive multifocal leukoencephalopathy with immune reconstitution inflammatory syndrome misdiagnosed as cerebral toxoplasmosis in an HIV-infected woman

A 53-year-old woman presenting with oral candidiasis was diagnosed with HIV-1 infection. The CD4 cell count nadir was 71 cells/mm (5%) and viral load was 445 000 copies/ml. Treatment was initiated with emtricitabine/tenofovir and boosted darunavir. One month later, she presented seizures with psychomotor slowdown, left upper-limb paresis, cerebellar syndrome, left homonymous hemianopsia, and cortical blindness. Her HIV viral