Abstract
We examined a child with a human immunodeficiency virus (HIV) infection who at 15 months of age developed acute encephalitis, followed 1 week later by a diffuse, uniocular retinochoroiditis. The clinical picture in the right eye was characterized by the occurrence of some intraretinal hemorrhages; punctate, yellow-white, outer retinal lesions temporal to the macula; and a quadrantal, white area of necrotic retina located superotemporally. — The vitreous was remarkably clear, and the left eye was normal. Fluorescein angiography revealed small spots of late hyperfluorescence, vasculitis in the posterior pole, and a persistently hypofluorescent quadrantal superotemporal area.Toxoplasma IgM antibodies that were absent 1 week after birth became detectable in the serum and the cerebrospinal fluid. Serological testing for cytomegalovirus was negative. Neurological signs improved on a specific therapy (pyrimethamine and sulfamethopirazine), but the patient died 2 months later of disseminated cytomegalovirus infection.
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Boyer DS (1983) Discussion of paper by Holland et al.: Acquired immunodeficiency syndrome; ocular manifestations. Ophthalmology 90:872–873
Doft BH, Gass JM (1985) Punctate outer retinal toxoplasmosis. Arch Ophthalmol 103:1332–1336
Fauci AS, Macher AM, Longo DL (1984) Acquired immunodeficiency syndrome: epidemiologic, clinical, immunologic and therapeutic considerations. Ann Intern Med 100:92–106
Gottlieb MS, Schroff R, Schanker HM (1981) Pneumocystic carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Engl J Med 305:1425–1431
Heinemann MH, Gold JM, Maisel J (1986) BilateralToxoplasma retinochoroiditis in a patient with acquired immunodeficiency syndrome. Retina 6:224–227
Holland GN (1988) Ocular infections with the acquired immunodeficiency syndrome. In: Ferraz de Oliveira LN (ed) Ophthalmology today. Proceedings of the VIIIth Congress of the European Society of Ophthalmology. Elsevier, Amsterdam, pp 95–102
Holland GN, Gottlieb MS, Yee RD (1982) Ocular disorders associated with a new severe acquired cellular immunodeficiency syndrome. Am J Ophthalmol 93:393–402
Holland GN, O’Connor GR, Diaz RF, Minasi P, Wara WM (1988) Ocular toxoplasmosis in immunosuppressed non-human primates. Invest Ophthalmol Vis Sci 29:835–842
Holland GN, Engstrom RE, Glasgow BJ, Berger BJ, Daniels SA, Sidikaro Y, Harmon JA, Fischer DH, Boyer DS, Rao NA, Eagle RC, Kreiger AE, Foos RY (1988) Ocular toxoplasmosis in patients with the acquired immunodeficiency syndrome. Am J Ophthalmol 106:653–667
Khaelem M, Kaligh SB, Goldsmith J, Fetkenhour C, O’Grady RB, Phair JP, Chrobak M (1984) Ophthalmologic findings in acquired immune deficiency syndrome (AIDS). Arch Ophthalmol 102:201–208
Palestine AG, Rodrigues MM, Macher AM, Chan CC, Lane HC, Fauci AS, Masur H, Longo D, Reichert CM, Steis R, Rook AH, Nussenblatt RB (1984) Ophthalmic involvement in acquired immunodeficiency syndrome. Ophthalmology 91:1092–1099
Parke DW, Font RL (1986) Diffuse toxoplasmic retinochoroiditis in a patient with AIDS. Arch Ophthalmol 104:571–575
Uchida Y, Kakehashi Y, Kameyama K (1978) Juxtapapillary retinochoroiditis with a psychiatric disorder possibly caused by toxoplasmosis: a case note. Am J Ophthalmol 86:791–798
Weiss A, Margo CE, Ledford DK, Locket RF, Brinser JH (1986) Toxoplasmic retinochoroiditis as an initial manifestation of the acquired immunodeficiency syndrome. Am J Ophthalmol 101:248–249
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Bottoni, F., Gonnella, P., Autelitano, A. et al. Diffuse necrotizing retinochoroiditis in a child with AIDS and toxoplasmic encephalitis. Graefe’s Arch Clin Exp Ophthalmol 228, 36–39 (1990). https://doi.org/10.1007/BF02764288
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DOI: https://doi.org/10.1007/BF02764288