A 48-year-old man is admitted to the hospital with a new diagnosis of HIV and Toxoplasma encephalitis. Treatment is immediately started with pyrimethamine, sulfadiazine, and leucovorin. Repeat brain imaging 2 weeks later demonstrates substantial improvement. He started on antiretroviral therapy, completed 6 weeks of acute therapy for Toxoplasma encephalitis, and then transitioned to chronic maintenance therapy (secondary prophylaxis). At a visit 18 months after the initial diagnosis of toxoplasmosis, the HIV RNA is undetectable (and has been undetectable for 15 months), the CD4 count has increased from a baseline of 34 cells/mm³ to 189 cells/mm³, and all neurologic symptoms have resolved.