Tick- borne infection revealing human immunodeficiency virus (HIV) positivity in a young adult

Purpose: To describe a patient whose retinal findings suggestive of tick-borne disease but evaluations led to early diagnosis and treatment of human immunodeficiency virus (HIV) infection. Observation: A young patient presented with bilateral uveitis, branch retinal artery occlusion and retinal findings suggestive of infective/inflammatory etiology. Laboratory evaluations revealed that the patient was positive for co-infection with Rickettsia conorii and Bartonella henselae. On further investigation, the patient tested positive for HIV infection. The patient was treated with doxycycline as well as highly active anti-retroviral therapy (HAART) to control both opportunistic infections as well as HIV infection. Conclusion and Importance: Patients with HIV infection are at risk for multiple, simultaneous opportunistic co-infections, including those with tick-borne diseases. Keywords: Tick-borne disease, Rickettsia, Bartonella, HIV, Ocular, Retina, Occlusive vasculitis, Chorioretinitis