Disseminated toxoplasmosis in a patient under methotrexate

A 60 years old patient treated by methotrexate and prednisolone for rheumatoid arthritis, was admitted at the hospital for pulmonary infection refractory to antibiotics. After a few days he was transferred to the intensive care unit for pancytopenia. Direct examination of bone marow revealed the presence of toxoplasma into polymorphonuclears and monocytes. However, in spite of a specific treatment the patient died two days later of disseminated toxoplasmosis.