Diffuse necrotizing retinochoroiditis in a child with AIDS and toxoplasmic encephalitis

We examined a child with a human immunodeficiency virus (HIV) infection who at 15 months of age developed acute encephalitis, followed 1 week later by a diffuse, uniocular retinochoroiditis. The clinical picture in the right eye was characterized by the occurrence of some intraretinal hemorrhages; p...

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Bibliographic Details
Published in:Graefe's archive for clinical and experimental ophthalmology 1990, Vol.228 (1), p.36-39
Main Authors: BOTTONI, F, GONNELLA, P, AUTELITANO, A, ORZALESI, N
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Acquired Immunodeficiency Syndrome - congenital
Acquired Immunodeficiency Syndrome - immunology
AIDS/HIV
Antibodies, Protozoan - blood
Antibodies, Protozoan - cerebrospinal fluid
Biological and medical sciences
Chorioretinitis - complications
Chorioretinitis - immunology
Encephalitis - complications
Encephalitis - etiology
Fluorescein Angiography
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infant
Magnetic Resonance Imaging
Medical sciences
T-Lymphocytes - immunology
Toxoplasmosis, Ocular - complications
Toxoplasmosis, Ocular - diagnosis
Toxoplasmosis, Ocular - immunology
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Summary:We examined a child with a human immunodeficiency virus (HIV) infection who at 15 months of age developed acute encephalitis, followed 1 week later by a diffuse, uniocular retinochoroiditis. The clinical picture in the right eye was characterized by the occurrence of some intraretinal hemorrhages; punctate, yellow-white, outer retinal lesions temporal to the macula; and a quadrantal, white area of necrotic retina located superotemporally. - The vitreous was remarkably clear, and the left eye was normal. Fluorescein angiography revealed small spots of late hyperfluorescence, vasculitis in the posterior pole, and a persistently hypofluorescent quadrantal superotemporal area. Toxoplasma IgM antibodies that were absent 1 week after birth became detectable in the serum and the cerebrospinal fluid. Serological testing for cytomegalovirus was negative. Neurological signs improved on a specific therapy (pyrimethamine and sulfamethopirazine), but the patient died 2 months later of disseminated cytomegalovirus infection.
ISSN:0721-832X
1435-702X
DOI:10.1007/BF02764288