A typical bilateral Toxoplasma retinochoroiditis in a bone marrow transplant patient with negative serum titers

Albert Hazan, Rakesh M. Patel, David Levinson, Umar K. Mian, David C. Gritz

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Toxoplasma retinochoroiditis can have an atypical presentation and be difficult to diagnose in immunocompromised patients. Accurate diagnosis and appropriate treatment is important since the disease can be aggressive in these patients. This paper is a case report with literature review, emphasizing on the diagnosis and treatment of Toxoplasma retinochoroiditis. Findings: A 27-year-old male with chronic myelogenous leukemia with history of bone marrow transplantation presented with floaters in his right eye. Fundus exam showed bilateral, multifocal retinochoroiditis with subsequent development of a mild vitritis. Serum cytomegalovirus and toxoplasmosis antibody titers and syphilis screen were negative. Aqueous polymerase chain reaction (PCR) analysis revealed the presence of Toxoplasma gondii DNA OU. Clindamycin (1.0 mg/0.1 mL) was injected bilateral intravitreal OU twice at 4 days apart with subsequent resolution of retinochoroiditis. Conclusions: When evaluating retinochoroiditis in an immunocompromised patient, one must keep a high index of suspicion for atypical presentations of well-known disease entities. Aqueous and vitreous samples for PCR can be useful in obtaining an accurate diagnosis and therefore provide appropriate management for the patient. Intravitreal clindamycin is an option for treatment in these patients.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalJournal of Ophthalmic Inflammation and Infection
Volume3
Issue number1
DOIs
StatePublished - 2013

Fingerprint

Toxoplasma
Bone Marrow
Transplants
Clindamycin
Immunocompromised Host
Serum
Polymerase Chain Reaction
Toxoplasmosis
Syphilis
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Cytomegalovirus
Bone Marrow Transplantation
Therapeutics
Antibodies
DNA

Keywords

  • Intravitreal clindamycin
  • Toxoplasma gondii
  • Toxoplasma retinochoroiditis

ASJC Scopus subject areas

  • Ophthalmology
  • Infectious Diseases

Cite this

A typical bilateral Toxoplasma retinochoroiditis in a bone marrow transplant patient with negative serum titers. / Hazan, Albert; Patel, Rakesh M.; Levinson, David; Mian, Umar K.; Gritz, David C.

In: Journal of Ophthalmic Inflammation and Infection, Vol. 3, No. 1, 2013, p. 1-4.

Research output: Contribution to journalArticle

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