CNS toxoplasmosis, a rare presentation in a patient with Myasthenia Gravis
Rachel King,
Poorani Sekar,
Henna Patel,
Maryam Naveed,
Sumaia Aqtash,
Shubham Adroja,
Denise Jacob,
Talha Riaz
Affiliations
Rachel King
Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA; Division of Infectious Diseases, Western Reserve Hospital, Cuyahoga falls, OH, USA
Poorani Sekar
Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Henna Patel
University-Heritage College of Osteopathic Medicine, Athens, OH, USA
Maryam Naveed
Division of Infectious Diseases, Department of Internal Medicine, Banner University Medical Center, Tucson, AZ, USA; Correspondence to: Division of Infectious Diseases, Banner-University Medical Center, Tucson, AZ, USA.
Sumaia Aqtash
Division of Infectious Diseases, Western Reserve Hospital, Cuyahoga falls, OH, USA
Shubham Adroja
Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA
Denise Jacob
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Talha Riaz
Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA; Division of Infectious Diseases, Western Reserve Hospital, Cuyahoga falls, OH, USA; Division of Infectious Diseases, Department of Internal Medicine, Banner University Medical Center, Tucson, AZ, USA; Correspondence to: Division of Infectious Diseases, University of Arizona Medical Center, Tucson, AZ, USA.
We report the case of a 78-year-old man with a past medical history of non-Hodgkin’s lymphoma s/p chemotherapy and Myasthenia Gravis on chronic mycophenolate mofetil (MMF), who presented with altered mental status and was found to have ring enhancing brain lesions. A brain biopsy revealed organisms consistent with Toxoplasma gondii. Cerebral toxoplasmosis has been rarely reported in patients with hematologic malignancies or in those receiving immunosuppressive agents. There needs to be a high degree of suspicion for T. gondii in HIV-negative individuals who are on immunosuppressants drugs including MMF.
