Note the arc-shaped tachyzoites, each with an eccentric nucleus, amid a background of host cell nuclei.
As pointed out by Anonymous, this used to be a pretty common scenario back in the early AIDS era. Fortunately CNS toxoplasmosis is now pretty rare in the HIV positive population due to the availability of good antiretroviral medications (in parts of the world, at least) and widespread use of prophylactic medications in susceptible medications.
I don't have the full history in this patient, but there was a question about the patient's compliance with prescribed medications.
Here's a poem from Blaine this week - a little on the dark side:
Old McDonald had a farm…E-I-E-I-O
And on his farm he had a cat…E-I-E-I-O
With a ‘meow meow’ here and a ‘meow meow’ there…
Poopin’ out oocysts everywhere.
Necrotic cortical lesions, oh the despair! E-I-E-I-O