summary 口A38year- old male a renal transplant 9 months prior, in use of steroids and FK506, MMF and TMP-SMX stopped a fever and chills for 2 weeks, sudden -onset faciobrachial monoparesis seizures and progressively deteriorating sensorium a Brain mRi and thoracic ct showed multiple lesions a Negative findings for cryptococcus, tb and malignant cells 口 Poorly react to meropenem, colistimethate sodium(多粘菌素), ganciclovir, and oral fluconazolesummary p A 38-year-old male p renal transplant 9 months prior, in use of steroids and FK506, MMF and TMP-SMX stopped p fever and chills for 2 weeks, sudden-onset faciobrachial monoparesis, seizures, and progressively deteriora<ng sensorium. p Brain MRI and thoracic CT showed mul<ple lesions p Nega<ve findings for cryptococcus, TB and malignant cells p Poorly react to meropenem, colis<methate sodium(多粘菌素), ganciclovir, and oral fluconazole