Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Cerebral Toxoplasmosis in a Patient on Methotrexate and Infliximab for Rheumatoid Arthritis
Swaroopa PulivarthiRwoof A. ReshiCarl T. McGaryMurali Krishna Gurram
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JOURNALS OPEN ACCESS

2015 Volume 54 Issue 11 Pages 1433-1436

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Abstract

Cerebral toxoplasmosis is a rare disease predominantly found in immunocompromised hosts. However, cerebral toxoplasmosis has not been frequently described in association with the use of immunosuppressive medications. We herein report a case of cerebral toxoplasmosis in a 76-year-old Caucasian woman on methotrexate and infliximab for rheumatoid arthritis. The patient presented with right facial droop, slurred speech and difficulty walking. In addition to receiving methotrexate and infliximab and owning a cat, she had no other obvious risk factors. Imaging studies were not conclusive; however, brain biopsy confirmed the diagnosis. Serology was positive for anti-toxoplasma immunoglobulin G. Cerebral toxoplasmosis should be included in the differential diagnosis of patients under immunosuppressive medication who present with neurological manifestations.

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© 2015 by The Japanese Society of Internal Medicine
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