AKI in a Patient with Cerebral Toxoplasmosis

Abstract

### Case Description A 59-year-old man, on mycophenolate mofetil and prednisone for long-standing polymyositis, presented to the emergency department with a 2-day history of flashes in his left eye. His vital signs and physical examination were unremarkable. Brain magnetic resonance imaging revealed multiple rim-enhancing lesions with perilesional edema. An extensive workup, including cerebrospinal fluid analysis, was unremarkable except for positive serum toxoplasma IgG antibody level. Mycophenolate mofetil was discontinued. Oral sulfadiazine (6 g/d) and pyrimethamine (75 mg/d) were initiated for suspected cerebral toxoplasmosis. After 2 days, the patient developed sudden onset flank pain and gross hematuria. His serum creatinine level acutely increased to 2.0 from 0.6 mg/dl (reference range 0.6–1.2 …