Blurred Vision and Gastrointestinal Bleeding in a Patient With HIV

A 57-year-old man with HIV (CD4 cell count, 16/mm3; HIV viral load >10 million copies/mL) had blurred vision, weight loss, and gastrointestinal bleeding. A sample of small bowel showed inflammation of the lamina propria, with numerous cytoplasmic and nuclear inclusions with an "owl eye"...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2022-01, Vol.327 (3), p.276-277
Main Authors: Christensen, Bradley W, Li, Hsiao C, Huerta, Sergio
Format: Article
Language:English
Subjects:
Bleeding
CD4 antigen
Cytomegalovirus Retinitis - complications
Cytomegalovirus Retinitis - diagnosis
Enteritis - complications
Enteritis - diagnosis
Gastrointestinal Hemorrhage - diagnosis
Gastrointestinal Hemorrhage - etiology
Hemorrhage
HIV
HIV Infections - complications
HIV Infections - diagnosis
HIV Infections - drug therapy
Human immunodeficiency virus
Humans
Inclusion bodies
Inclusions
Lamina propria
Lymphoma, Large B-Cell, Diffuse - diagnosis
Lymphoma, Large B-Cell, Diffuse - diagnostic imaging
Lymphoma, Large B-Cell, Diffuse - drug therapy
Lymphoma, Large B-Cell, Diffuse - pathology
Male
Middle Aged
Vision
Vision Disorders - virology
Weight loss
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Summary:A 57-year-old man with HIV (CD4 cell count, 16/mm3; HIV viral load >10 million copies/mL) had blurred vision, weight loss, and gastrointestinal bleeding. A sample of small bowel showed inflammation of the lamina propria, with numerous cytoplasmic and nuclear inclusions with an "owl eye" appearance; dilated retinal examination revealed extensive macular hemorrhage with peripapillary whitening. What is the diagnosis and what would you do next?
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2021.21510