Cytomegalovirus retinitis in a patient with non-Hodgkin's lymphoma: a diagnostic dilemma.
OBJECTIVE
Patients with lymphoma can rarely develop cytomegalovirus (CMV) retinitis. Clinically it is difficult to distinguish from intraocular lymphoma. Also, in such cases the CD4+ count may be high. The authors report a rare case of bilateral CMV retinitis in a patient with non-Hodgkin's lymphoma with high CD4+ counts.


METHODS
Observational case report with review of literature.


RESULTS
CMV retinitis was clinically suspected due to the presence of large areas of retinal necrosis and hemorrhages in one eye and a demarcation line with white mottled retina in the other eye. Other differential diagnoses considered were intraocular lymphomatous infiltration and acute retinal necrosis due to herpes group of viruses. The diagnosis of CMV retinitis was confirmed by polymerase chain reaction performed on vitreous sample.


CONCLUSIONS
CMV retinitis can develop in cases of lymphoma despite high CD4+ counts. An early diagnosis can be established by performing PCR on vitreous biopsy.
Chawla
R
R
Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
Venkatesh
P
P
Garg
S P
SP
Mandal
S
S
Tewari
H K
HK
D000328:Adult; D018791:CD4 Lymphocyte Count; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D008297:Male; D016133:Polymerase Chain Reaction; D014822:Vitreous Body / Q000821:virology
D004279:DNA, Viral