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Toxoplasma Gondii Encephalitis from Mycophenolate Mofetil: A Case Report and Review

Singer JL and De La Pena N

Mycophenolate mofetil (MMF) is often used in the treatment of autoimmune diseases such as myasthenia gravis and the prevention of organ rejection after transplantation. Toxoplasma encephalitis (TE) is typically associated with human immunodeficiency virus (HIV) infection. We present a case of an HIV sero-negative woman who developed TE after long-term MMF therapy for the treatment of myasthenia gravis. TE can occur even with low doses of MMF. A high index of suspicion is needed for patients presenting with focal neurologic deficits given poor outcomes in the majority of reported cases. Prophylaxis against TE can be considered although further study is needed.