[Acquired ocular toxoplasmosis and immunosuppression of tumoral thymic origin].
A rare case of acute bilateral unifocal chorioretinitis in a 24 years old man is described. The patient had been followed for more than 3 years for a benign thymoma, detected by systematic radiography, that was initially operated on with success. Later, after recurrence of clinical signs a second operation was performed that revealed local invasion of the tumor which was histologically identified as a benign, lymphoid thymoma. Serological data permitted us to attribute the lesions to a sub-acute ganglionary toxoplasmosis, contracted five months before any ocular localization. A treatment including local corticotherapy and oral pyrimethamine and sulfonamide was undertaken. Healing of the retinal lesions occurred slowly. A complete study of the patient's immunity revealed an important deficiency of cell-mediated functions. The problem of diagnosis of opportunistic chorioretinitis is discussed. In patients with impairment of cellular-type immunity, the following are commonly observed: herpes group viral diseases (including cytomegalic inclusion disease), fungus diseases (candida, aspergillus, mucormycosis, cryptococcus), and, rarely, toxoplasmosis. The presence of specific serum antibodies is the most important element in making a diagnosis, considering that the ophthalmoscopic appearance and clinical course may vary.
D000328:Adult; D001082:Aqueous Humor / Q000276:immunology; D002825:Chorioretinitis / Q000209:etiology*; D003937:Diagnosis, Differential; D006801:Humans; D007111:Immunity, Cellular; D007075:Immunoglobulin M / Q000032:analysis; D008206:Lymphatic Diseases / Q000175:diagnosis; D008297:Male; D013945:Thymoma / Q000150:complications / Q000276:immunology*; D013953:Thymus Neoplasms / Q000150:complications / Q000276:immunology*; D014123:Toxoplasmosis / Q000175:diagnosis; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology
D007075:Immunoglobulin M
Toxoplasmose oculaire acquise et immunodépression d'origine thymique tumorale.