Toxoplasma encephalitis in a patient receiving cyclosporine monotherapy for Behçet disease

We report a 44-year-old woman with toxoplasma encephalitis that occurred during cyclosporine monotherapy for Behçet disease. She had been treated with cyclosporine for 8 years. She experienced headache and, nausea, and then consciousness disturbance developed. Brain MRI showed high-signal intensity lesions on T1-weighted MRI with Gd-enhancement in the left temporoparietal lobe, right thalamus and right frontal and temporal lobes. The pathological examination of the biopsied brain specimens suggested toxoplasma encephalitis. She improved rapidly after the administration of antibiotics for toxoplasma gondii. Anti-toxoplasma specific protein antibodies were positive in the serum and CSF, supporting a diagnosis of acute toxoplasmosis. Toxoplasma encephalitis due to cyclosporine mono-therapy has not been reported yet. The measurement of anti-toxoplasma specific protein antibodies may be useful for the early, accurate diagnosis of toxoplasmosis.