Acquired toxoplasmic retinitis in an immunosuppressed patient: diagnosis by transvitreal fine-needle aspiration biopsy.
BACKGROUND
Acquired multifocal white retinal lesions in an immunosuppressed patient are diagnostically challenging.


METHODS
Case report of a 34-year-old woman who underwent bone marrow transplantation for chronic myelogenous leukemia. Four months after the transplant, while on relatively high doses of immunosuppressive drugs, she developed bilateral multifocal retinitis versus leukemic retinal infiltration. Fine-needle aspiration biopsy was performed on one eye in an attempt to establish a cytological diagnosis.


RESULTS
The aspirate was found to contain individual crescent-shaped intraretinal organisms and cysts, consistent with the diagnosis of toxoplasmic retinitis. The patient was started immediately on an anti-toxoplasmosis regimen consisting of sulfadiazine, pyrimethamine, and folinic acid. Follow-up examinations revealed complete inactivation of the retinitis and no delayed complications of the biopsy.


CONCLUSIONS
Fine-needle aspiration biopsy can be a useful diagnostic tool in selected patients with acquired retinal infiltrates.
Palkovacs
Elizabeth M
EM
Department of Ophthalmology, University of Cincinnati College of Medicine, P.O. Box 670527, Cincinnati, OH 45267-0527, USA. elsapalkovacs@gmail.com
Correa
Zelia
Z
Augsburger
James J
JJ
Eagle
Ralph C
RC
D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D016026:Bone Marrow Transplantation; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D002955:Leucovorin / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000276:immunology / Q000628:therapy; D011739:Pyrimethamine / Q000627:therapeutic use; D012173:Retinitis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D013411:Sulfadiazine / Q000627:therapeutic use; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D014822:Vitreous Body / Q000469:parasitology
D000981:Antiprotozoal Agents; D007166:Immunosuppressive Agents; D013411:Sulfadiazine; D002955:Leucovorin; D011739:Pyrimethamine