Atypical toxoplasmic retinochoroiditis.
We report a case of re-activation of Toxoplasma gondii as a cause of atypical retinal necrosis in an immunocompetent individual. The rapid development of necrotising confluent retinochoroiditis and vitreous inflammation necessitated urgent aqueous humor PCR analysis, which was positive for T gondii. The patient was treated with two intravitreal injections of clindamycin, along with oral sulphadiazine, pyrimethamine, folinic acid and prednisolone. He developed central retinal arterial occlusion, as a complication of toxoplasmic retinochoroiditis, and immediate anterior chamber paracentesis was performed with visual recovery. The injection of intravitreal clindamycin with concomitant oral therapy was associated with control of toxoplasmic retinochoroiditis and resolution of vitreous inflammation.
Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, UK.
Sofia
S
Theodoropoulou
Conrad
C
Schmoll
Kate
K
Templeton
Baljean
B
Dhillon
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000962:Antimalarials / Q000008:administration & dosage; D001082:Aqueous Humor / Q000382:microbiology; D002825:Chorioretinitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D002981:Clindamycin / Q000008:administration & dosage*; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D016133:Polymerase Chain Reaction; D011739:Pyrimethamine / Q000008:administration & dosage*; D014122:Toxoplasma / Q000235:genetics / Q000302:isolation & purification*; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000962:Antimalarials; D004269:DNA, Bacterial; D002981:Clindamycin; D011739:Pyrimethamine