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A 55-year-old man presented with a two-day history of headache, fever, and generalized weakness. He had received a cadaveric kidney transplant five years earlier. His medications included 5 mg of tacrolimus twice a day and 10 mg of prednisone daily. On neurologic examination, he was confused and incoherent. Cranial nerves were normal, but he had a hazy left retina. Strength examination showed an inability to overcome minimal resistance, more prominent on the right side. Deep tendon reflexes were exaggerated. Magnetic resonance imaging of the brain with the administration of gadolinium showed multiple enhancing lesions in both cerebral hemispheres (Panels A . . . [Full Text of this Article] |
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