Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis

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Author(s)

    • Matsuura Jun
    • Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
    • Mizuta Ikuko
    • Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan
    • Norose Kazumi
    • Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, Japan
    • Mizuno Toshiki
    • Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan

Abstract

<p>A 65-year-old woman with rheumatoid arthritis (RA) visited our hospital because of right facial sensory hypoesthesia. Cerebral toxoplasmosis was suspected on brain magnetic resonance imaging. We discontinued methotrexate for RA and started a sulfamethoxazole/trimethoprim (ST) mixture. Although ST treatment was interrupted because of adverse reactions, her prognosis was favorable. The <i>Toxoplasma</i> 18S rDNA gene was detected by nested-polymerase chain reaction (PCR) from blood and cerebrospinal fluid. Detecting the <i>Toxoplasma</i> 18S rDNA gene by nested-PCR is useful for the diagnosis and safer than a brain biopsy. In addition, the discontinuation of immunosuppressants may be recommended in patients compromised by those immunosuppressants. </p>

Journal

  • Internal Medicine

    Internal Medicine 57(10), 1463-1468, 2018

    The Japanese Society of Internal Medicine

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