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Bilateral Toxoplasma Retinochoroiditis Simulating Cytomegalovirus Retinitis in an Allogeneic Bone Marrow Transplant Patient

A 36-year old female with acute myelogenous leukemia presented with a sudden decrease in vision one month following bone marrow transplantation (BMT). She had been taking multiple immunosuppressants to treat her recently-developed graft-versus-host-disease (GVHD). Visual acuity was 20/60 in her righ...

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Autores principales: Chung, Hyewon, Kim, June-Gone, Choi, Sang-Ho, Lee, Sun Young, Yoon, Young Hee
Formato: Texto
Lenguaje:English
Publicado: The Korean Ophthalmological Society 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629896/
https://www.ncbi.nlm.nih.gov/pubmed/18784451
http://dx.doi.org/10.3341/kjo.2008.22.3.197
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author Chung, Hyewon
Kim, June-Gone
Choi, Sang-Ho
Lee, Sun Young
Yoon, Young Hee
author_facet Chung, Hyewon
Kim, June-Gone
Choi, Sang-Ho
Lee, Sun Young
Yoon, Young Hee
author_sort Chung, Hyewon
collection PubMed
description A 36-year old female with acute myelogenous leukemia presented with a sudden decrease in vision one month following bone marrow transplantation (BMT). She had been taking multiple immunosuppressants to treat her recently-developed graft-versus-host-disease (GVHD). Visual acuity was 20/60 in her right eye and 20/25 in her left. Ophthalmic examination revealed mild inflammatory reaction in both the anterior chamber and the vitreous of both eyes, as well as densely opaque yellow-white infiltrates with well-demarcated borders in the posterior retina of both eyes. She was originally diagnosed as CMV retinitis, but treatment with ganciclovir failed to improve her ocular condition. Subsequent work-up, including serology and brain MRI, led to a diagnosis of combined ocular and cerebral toxoplasmosis. After 6 weeks of antiparasitic therapy, her retinal lesions became inactive and her cerebral lesions improved. Immunosuppressed patients with necrotizing retinochoroiditis should be suspected of having toxoplasmosis. Accurate differentiation between this condition and CMV, and early intervention with the appropriate treatment may be critical to preserve the best vision.
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spelling pubmed-26298962009-02-25 Bilateral Toxoplasma Retinochoroiditis Simulating Cytomegalovirus Retinitis in an Allogeneic Bone Marrow Transplant Patient Chung, Hyewon Kim, June-Gone Choi, Sang-Ho Lee, Sun Young Yoon, Young Hee Korean J Ophthalmol Case Report A 36-year old female with acute myelogenous leukemia presented with a sudden decrease in vision one month following bone marrow transplantation (BMT). She had been taking multiple immunosuppressants to treat her recently-developed graft-versus-host-disease (GVHD). Visual acuity was 20/60 in her right eye and 20/25 in her left. Ophthalmic examination revealed mild inflammatory reaction in both the anterior chamber and the vitreous of both eyes, as well as densely opaque yellow-white infiltrates with well-demarcated borders in the posterior retina of both eyes. She was originally diagnosed as CMV retinitis, but treatment with ganciclovir failed to improve her ocular condition. Subsequent work-up, including serology and brain MRI, led to a diagnosis of combined ocular and cerebral toxoplasmosis. After 6 weeks of antiparasitic therapy, her retinal lesions became inactive and her cerebral lesions improved. Immunosuppressed patients with necrotizing retinochoroiditis should be suspected of having toxoplasmosis. Accurate differentiation between this condition and CMV, and early intervention with the appropriate treatment may be critical to preserve the best vision. The Korean Ophthalmological Society 2008-09 2008-09-10 /pmc/articles/PMC2629896/ /pubmed/18784451 http://dx.doi.org/10.3341/kjo.2008.22.3.197 Text en Copyright © 2008 The Korean Ophthalmological Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Chung, Hyewon
Kim, June-Gone
Choi, Sang-Ho
Lee, Sun Young
Yoon, Young Hee
Bilateral Toxoplasma Retinochoroiditis Simulating Cytomegalovirus Retinitis in an Allogeneic Bone Marrow Transplant Patient
title Bilateral Toxoplasma Retinochoroiditis Simulating Cytomegalovirus Retinitis in an Allogeneic Bone Marrow Transplant Patient
title_full Bilateral Toxoplasma Retinochoroiditis Simulating Cytomegalovirus Retinitis in an Allogeneic Bone Marrow Transplant Patient
title_fullStr Bilateral Toxoplasma Retinochoroiditis Simulating Cytomegalovirus Retinitis in an Allogeneic Bone Marrow Transplant Patient
title_full_unstemmed Bilateral Toxoplasma Retinochoroiditis Simulating Cytomegalovirus Retinitis in an Allogeneic Bone Marrow Transplant Patient
title_short Bilateral Toxoplasma Retinochoroiditis Simulating Cytomegalovirus Retinitis in an Allogeneic Bone Marrow Transplant Patient
title_sort bilateral toxoplasma retinochoroiditis simulating cytomegalovirus retinitis in an allogeneic bone marrow transplant patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629896/
https://www.ncbi.nlm.nih.gov/pubmed/18784451
http://dx.doi.org/10.3341/kjo.2008.22.3.197
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