title: Reactivation of toxoplasma retinochoroiditis under atovaquone therapy in an immunocompetent patient.
abstract: OBJECTIVE
  To report a case of toxoplasma retinochoroiditis reactivation in an immunocompetent patient under atovaquone therapy.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A healthy woman with a history of bilateral toxoplasma retinochoroiditis since childhood presented with a reactivation of toxoplasma retinochoroiditis. Because earlier treatment regimens had either produced intolerable side effects and/or were deemed ineffective for the prevention of reactivation, the patient was started on atovaquone suspension (750 mg three times a day). After initial regression of the lesion and still under atovaquone therapy, the patient presented again five weeks later with worsened best-corrected visual acuity. Examination showed that the lesion had expanded again and more cells were present in the vitreous.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of a reactivation of toxoplasma retinochoroiditis in an immunocompetent patient under atovaquone therapy, possibly indicating tachyzoite resistance to atovaquone.
authors.affiliation: Recklinghausen Eye Center, Recklinghausen, Germany. holger.baatz@augenzentrum.org
authors.forename: Holger
authors.initials: H
authors.lastname: Baatz
authors.forename: Alireza
authors.initials: A
authors.lastname: Mirshahi
authors.forename: Joachim
authors.initials: J
authors.lastname: Puchta
authors.forename: Hermann
authors.initials: H
authors.lastname: Gümbel
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Hattenbach
mesh_terms: D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000032:analysis; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D053626:Atovaquone; D002825:Chorioretinitis / Q000188:drug therapy / Q000276:immunology / Q000469:parasitology*; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007121:Immunocompetence; D009285:Naphthoquinones / Q000627:therapeutic use*; D010088:Oxidoreductases; D012008:Recurrence; D014122:Toxoplasma / Q000276:immunology; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy / Q000276:immunology / Q000469:parasitology*; D014792:Visual Acuity
chemical_list: D000913:Antibodies, Protozoan; D000981:Antiprotozoal Agents; D009285:Naphthoquinones; D010088:Oxidoreductases; D053626:Atovaquone