Choroiditis in a HIV-infected patient with disseminated cryptococcal infection: A case report and literature review

AbstractBackgroundOcular involvement in AIDS patients is a common event mainly caused by inflammation or infection. Despite the high prevalence rate of cryptococcosis in these individuals, ocular features have been occasionally described.Case reportA 20-year-old Brazilian female with HIV infection r...

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Bibliographic Details
Published in:Revista iberoamericana de micología 2019-07, Vol.36 (3), p.155-159
Main Authors: Heitor, Danilo Florentino, Mora, Delio Jose, Damasceno Escoura, Alessandro Henrique, Micheletti, Adilha Misson Rua, Torres, Rafael Garcia, Gazotto, Fernanda Castro, Pardi, Thiago Cesar, Rosa Junior, Adair da Silva, Silva Vergara, Mario León
Format: Article
Language:English
Subjects:
AIDS
Choroiditis
Coroiditis
Cryptococcus neoformans
Disseminated infection
Endoftalmitis
Endophthalmitis
Genotipo VNI
Infección diseminada
Infectious Disease
Sida
VNI genotype
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Summary:AbstractBackgroundOcular involvement in AIDS patients is a common event mainly caused by inflammation or infection. Despite the high prevalence rate of cryptococcosis in these individuals, ocular features have been occasionally described.Case reportA 20-year-old Brazilian female with HIV infection recently diagnosed was admitted with a respiratory profile presumptively diagnosed as Pneumocystis jirovecii pneumonia; an ophthalmologic exam suggested choroiditis by this agent as well. She was complaining of headaches and blurred vision which led to cryptococcal meningitis diagnosis by a CSF positive India ink stain and Cryptococcus neoformans positive culture. Despite therapy based on amphotericin B plus fluconazole, her clinical state progressively worsened and the patient died one week later. At necropsy, disseminated cryptococcal infection was evidenced in several organs including eyes, which presented bilateral chorioretinitis. ConclusionsCryptococcal ocular involvement in AIDS patients has been occasionally proved among the cases already reported. Thus, the post mortem exam is still pivotal to improve the quality of the clinical diagnosis, especially in limited-resource settings.
ISSN:1130-1406
DOI:10.1016/j.riam.2019.04.004