Rapid progression of neurotoxoplasmosis in a patient with concomitant rheumatoid arthritis and systemic lupus erythematous

CNS toxoplasmosis, a rare presentation in a patient with Myasthenia Gravis

“… Author, year, Ref. Age (years)/Gender Disease Immunosuppressant drugs Serology and microbiology Neuropathology Treatment Follow up Savsek et al, 2014 [1] 62, F Diffuse large B cell lymphoma, R-CHOP R-LP (rituximab and chlorambucil), R-FC (rituximab, chlorambucil, and cyclophosphamide), and R-CHOP Serology and blood PCR positive for T. gondii N/A Sulfadiazine, pyrimethamine, and folic acid for 6 weeks Mild cognitive deficits on a 3-month follow-up; continued with prophylactic doses of Sulfadiazine, pyrimethamine, and folic acid Lee et al, 2020 [3] 58, M Myasthenia gravis, T2DM MMF and prednisolone Serum Toxoplasma IgG positive Underwent 3 brain biopsies; third brain tissue specimen Toxoplasma PCR positive Sulfadiazine, pyrimethamine, and folic acid for 6 weeks Complete resolution after 6 weeks followed by low-dose secondary prophylaxis with Sulfadiazine, pyrimethamine, and folic acid Oliveira., et al 2018 [14] 60, F RA and SLE Prednisone, methotrexate, leflunomide Positive T. gondii antibodies Cerebral parenchymal perivascular lymphocytic pattern and suppurative areas, Toxoplasma gondii tachyzoites identified Pyrimethamine and sulfadiazine for 7 days Death Assimakopoulos et al, 2015 [8] 33, F Ulcerative colitis Prednisone and azathioprine T. gondii specific IgM positive but IgG negative. CSF Gram stain noted for pseudocyst containing bradyzoites Not done Pyrimethamine, folinic acid, and clindamycin for 4 weeks Complete recovery Lee et al, 2019 [11] 52, F Pemphigus Vulgaris MMF, prednisone, azathioprine, and rituximab Plasma-based next generation sequencing assay (Karius test) was positive for cell-free Toxoplasma DNA Not done Pyrimethamine and leucovorin for 6 weeks, later to TMP-SMX for 6 weeks Complete recovery; TMP-SMX once daily as maintenance Sasson et al, 2016 [12] 54, F …”

Neurotoxoplasmosios After Rituximab Therapy in Diffused Proliferative Glomerulonephritis Patient

“…2020; 12(1):e99996. be checked at the same time (8). The seropositive status of the patients can also be helpful helps in close monitoring and starting early treatment.…”