Inflammatory myopathy and acquired immunodeficiency syndrome

A 33-year-old black woman with advanced acquired immunodeficiency syndrome (AIDS) presented with rapidly progressive muscle weakness and serologic and radiologic evidence of central nervous system Toxoplasma infection. Muscles biopsy revealed an inflammatory infiltrate predominantly composed of macrophages and T suppressor/citotoxic cells. Human immunodeficiency virus major core protein (p24) was also detected in macrophages and damaged muscle cells around the inflammatory infiltrates. The patient improved clinically with glucocorticoid therapy for polymyositis and pyri-methamine and clindamycin therapy for toxoplasmosis.