title: Choroidoretinal granuloma in a young female patient.
abstract: A 16-year-old Brazilian female patient presented with blurring of vision in the right eye. Corrected visual acuity was OD 2/20, OS 20/20. Afferent pupillary defect was absent and anterior segment examination revealed anterior uveitis. Fundus examination showed light vitritis and a raised grey-white granuloma located at posterior pole with focal serous retinal detachment on optical coherence. Indocyacnine green angiography disclosed a complete mask effect in granuloma's area. Differential diagnoses were infectious (bacterial, viral, fungal and parasites) diseases, systemic inflammatory diseases, tumours. Blood serologies (HIV, toxoplasma, Borrelia, cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), rubeola) showed positive results for IgM and IgG for toxoplasma, and anterior chamber tap (PCR for toxoplasma, CMV, HSV, VZV) revealed toxoplasma DNA. Anti-toxoplasma therapy, pyrimethamine, sulfadiazine and calcium folinate, was administered immediately. On follow-up granuloma regression was observed, with complete visual restoration. This case demonstrates a clinically challenging posterior pole granuloma.
authors.affiliation: Department of Ophthalmology, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Horace F
authors.initials: HF
authors.lastname: Massa
authors.forename: Zisis
authors.initials: Z
authors.lastname: Gatzioufas
authors.forename: Georgios
authors.initials: G
authors.lastname: Mangioris
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Panos
mesh_terms: D000293:Adolescent; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D006801:Humans; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis / Q000188:drug therapy
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