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Brief report
Mohammad Zarei
Farabi Eye Hospital
Corresponding Author
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Background: The aim is to report an atypical presentation of ocular toxoplasmosis which led to the diagnosis of Acquired Immunodeficiency Syndrome (AIDS).
Case report: The 38-year-old woman was referred with metamorphopsia and reduced vision in the right eye in the past 3 weeks. Slit-lamp examination revealed granulomatous keratic precipitates (KPs), 2+ cells in the anterior chamber, and posterior synechiae. Fundus examination was remarkable for a white patch surrounding a scar, inferonasal to the optic disc with fibrous bands were emanating from the lesion and the retina around this region was detached with considerable extension towards periphery, while no breaks could be appreciated. She mentioned anorexia and losing 10 kg in the past three months and bilateral angular cheilitis was observed on systemic evaluation. The results of the patient's complete blood count revealed bicytopenia and CD4 lymphocytes: 79 cells/µl. Enzyme-linked immunosorbent assays (ELISA) for HIV antibodies came back positive which was later confirmed with the Western-blot test. Brain Magnetic Resonance Imaging (MRI) showed multiple ring-enhancing lesions in both cerebral cortices. Patient underwent Anti-Toxoplasmosis and Anti-HIV treatment and serous retinal detachment was completely resolved.
Conclusion: This report highlights the fact that sometimes the eyes are the site of the first presentation of a systemic life-threatening condition and emphasizes the role of ophthalmologists in such cases. In cases of atypical presentation, appropriate laboratory tests and CNS imaging should be requested. Systemic treatment with anti-toxoplasmosis regimens and HAART is mandatory in AIDs patients with ocular toxoplasmosis.
Keywords
Immunodeficiency Syndrome, Atypical Ocular Toxoplasmosis, case report
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This is a preprint. It has not completed peer review.
Brief report
Mohammad Zarei
Farabi Eye Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 15 Mar, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The aim is to report an atypical presentation of ocular toxoplasmosis which led to the diagnosis of Acquired Immunodeficiency Syndrome (AIDS).
Case report: The 38-year-old woman was referred with metamorphopsia and reduced vision in the right eye in the past 3 weeks. Slit-lamp examination revealed granulomatous keratic precipitates (KPs), 2+ cells in the anterior chamber, and posterior synechiae. Fundus examination was remarkable for a white patch surrounding a scar, inferonasal to the optic disc with fibrous bands were emanating from the lesion and the retina around this region was detached with considerable extension towards periphery, while no breaks could be appreciated. She mentioned anorexia and losing 10 kg in the past three months and bilateral angular cheilitis was observed on systemic evaluation. The results of the patient's complete blood count revealed bicytopenia and CD4 lymphocytes: 79 cells/µl. Enzyme-linked immunosorbent assays (ELISA) for HIV antibodies came back positive which was later confirmed with the Western-blot test. Brain Magnetic Resonance Imaging (MRI) showed multiple ring-enhancing lesions in both cerebral cortices. Patient underwent Anti-Toxoplasmosis and Anti-HIV treatment and serous retinal detachment was completely resolved.
Conclusion: This report highlights the fact that sometimes the eyes are the site of the first presentation of a systemic life-threatening condition and emphasizes the role of ophthalmologists in such cases. In cases of atypical presentation, appropriate laboratory tests and CNS imaging should be requested. Systemic treatment with anti-toxoplasmosis regimens and HAART is mandatory in AIDs patients with ocular toxoplasmosis.
Figure 1
Figure 2
Figure 3
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