Diffuse necrotizing retinochoroiditis in a child with AIDS and toxoplasmic encephalitis.
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.
Bottoni
F
F
Institute of Biomedical Science, University Eye Clinic, S. Paolo Hospital, Milano, Italy.
Gonnella
P
P
Autelitano
A
A
Orzalesi
N
N
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000151:congenital / Q000276:immunology; D000913:Antibodies, Protozoan / Q000097:blood / Q000134:cerebrospinal fluid; D002825:Chorioretinitis / Q000150:complications* / Q000276:immunology; D004660:Encephalitis / Q000150:complications* / Q000209:etiology; D005451:Fluorescein Angiography; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D013601:T-Lymphocytes / Q000276:immunology; D014126:Toxoplasmosis, Ocular / Q000150:complications* / Q000175:diagnosis / Q000276:immunology
D000913:Antibodies, Protozoan