Immune-recovery posterior uveitis associated with inactive isolated toxoplasmic retinochoroiditis in a patient with human immunodeficiency virus.

Abstract

PURPOSE:

To report a case of severe panuveitis in a patient with human immunodeficiency virus that developed after inactivation of toxoplasmic retinochoroiditis. The patient also developed cerebral toxoplasmosis.

METHODS:

A patient with human immunodeficiency virus who developed immune-recovery posterior uveitis in the context of inactive toxoplasmic retinochoroiditis underwent complete ophthalmologic evaluation, polymerase chain reaction of the aqueous humor, diagnostic vitrectomy, and cerebral ancillary testing.

RESULTS:

Polymerase chain reaction-confirmed toxoplasmic retinochoroiditis healed with appropriate treatment, but 2 months later coinciding with systemic immune restoration, the brain lesions worsened and immune-recovery panuveitis caused decreased visual acuity. Diagnostic vitrectomy confirmed only inflammatory cells.

CONCLUSION:

Immune-recovery panuveitis caused by cytomegalovirus retinitis is well documented, but we found only one published case caused by toxoplasma. Immune-recovery panuveitis should not be ruled out despite the absence of previous cytomegalovirus retinitis. A patient with human immunodeficiency virus who has had an intraocular opportunistic infection, despite resolution, must be followed-up by an ophthalmologist in collaboration with an infectious disease specialist to prevent blindness.

• Authors: Susana Ruiz Bilbao, Sandra Gómez Sánchez, Cristina Tural Llacher, Ramón Anglada Escalona, Laura Broc Iturralde, Alberto Aranda Yus, Guillem Sirera Jimenez, Bonaventura Clotet
• Journal: Retinal cases & brief reports (Retin Cases Brief Rep) Vol. 6 Issue 1 Pg. 105-8 ( 2012) ISSN: 1935-1089 [Print] United States
• PMID: 25390726 (Publication Type: Journal Article)