Toxoplasmic encephalitis and cytomegaloviral retinitis in a non-AIDS patient with chronic renal failure undergoing corticosteroid therapy]

We report a rare case of toxoplasmic encephalitis in a non-AIDS patient A 62-year-old man undergoing hemodialysis for seven months and corticosteroid therapy for rapidly progressive glomerulonephritis and admitted for generalized convulsions was found in cranial magnetic resonance imaging (MRI) to have multiple ring-enhanced lesions. Antibodies against Toxoplasma gondii, and in Sabin-Feldman dye test were extremely high, yielding a diagnosis of toxoplasmic encephalitis. He was also diagnosed as having cytomegaloviral retinitis. Anti-HIV antibody was negative. Treatment with pyrimethamine and clindamycin was effective and intracerebral lesions disappeared. Physicians encounting a similar situation should consider toxoplasmic encephalitis as a differential diagnosis, even in non-HIV patients, and implement confirmational examination.