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[Atypical ocular toxoplasmosis with concomitant ocular reactivation of varicella-zoster virus and cytomegalovirus in an immunocompromised host].
- Source :
-
Klinische Monatsblatter fur Augenheilkunde [Klin Monbl Augenheilkd] 2008 Mar; Vol. 225 (3), pp. 236-9. - Publication Year :
- 2008
-
Abstract
- Background: Necrotising retinopathy in immunocompromised hosts is characterised by an unfavourable course often with unspecific clinical features. Therefore, differential diagnosis can be critical.<br />History and Signs: A case of an initially therapy-resistant, necrotizing retinopathy is presented in a 65-year-old immunocompromised male patient suffering from chronic B-cell leukemia.<br />Therapy and Outcome: Despite demonstration of cytomegalovirus and Varicella-Zoster-Virus DNA by polymerase chain reaction in vitreous, aqueous humour samples and from retinal biopsy with specific antiviral therapy, a progression of retinal necrosis was noted. Finally Toxoplasma gondii DNA was detected and retinal necrosis resolved after specific treatment. However, visual acuity remains poor because of optic nerve atrophy.<br />Conclusions: The polymerase chain reaction is an important diagnostic tool for differential diagnosis in immunocompromised patients suffering from necrotising retinopathy. If resistance to therapy is noted atypical ocular toxoplasmosis should be considered. The presented case report shows that even multiple infections are possible in the same host.
- Subjects :
- Aged
Antineoplastic Combined Chemotherapy Protocols adverse effects
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Blindness diagnosis
Blindness immunology
Chlorambucil administration & dosage
Chlorambucil adverse effects
Chorioretinitis immunology
Comorbidity
Cytomegalovirus Infections immunology
Follow-Up Studies
Herpes Zoster Ophthalmicus immunology
Humans
Immune Tolerance immunology
Leukemia, Lymphocytic, Chronic, B-Cell drug therapy
Male
Opportunistic Infections immunology
Optic Atrophy diagnosis
Optic Atrophy immunology
Prednisolone administration & dosage
Prednisolone adverse effects
Retinal Necrosis Syndrome, Acute diagnosis
Retinal Necrosis Syndrome, Acute immunology
Toxoplasmosis, Ocular immunology
Chorioretinitis diagnosis
Cytomegalovirus physiology
Cytomegalovirus Infections diagnosis
Herpes Zoster Ophthalmicus diagnosis
Herpesvirus 3, Human physiology
Leukemia, Lymphocytic, Chronic, B-Cell immunology
Opportunistic Infections diagnosis
Toxoplasmosis, Ocular diagnosis
Virus Activation immunology
Subjects
Details
- Language :
- German
- ISSN :
- 0023-2165
- Volume :
- 225
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Klinische Monatsblatter fur Augenheilkunde
- Publication Type :
- Academic Journal
- Accession number :
- 18351539
- Full Text :
- https://doi.org/10.1055/s-2008-1027146