1st August 2023

A 52-year-old man with a background of intravenous drug use is brought to A&E by ambulance.

A 52-year-old man with a background of intravenous drug use is brought to A&E by ambulance. His friend is with him and reports he has not used any drugs that day, but for the past couple of days has been unwell with a headache and vomiting before having a seizure today. He has no history of epilepsy. His HIV status is unknown.

Imaging confirms a diagnosis of a cerebral abscess, most likely secondary to toxoplasmosis.

What is the first line treatment?

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