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. Muscle biopsy revealed an inflammatory infiltrate predominantly composed of macrophages and T suppressorkytotoxic 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 pyrimethamine and clindamycin therapy for toxoplasmosis.In patients with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC), the musculoskeletal system may be involved secondary to peripheral neuropathy, by direct infection, or by an autoimmune inflammatory process (1-9). The etiology of polymyositis in patients with acquired immunodeficiency is unknown, although other autoimmuneThe opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.