Active toxoplasma chorioretinitis in immunocompromised patients: a case series


Kayabaşı M., Mammadov T., Köksaldı S., Arıkan G., Kaynak S., Saatci A. O., ...More

Archieve of Clinical Cases, vol.11, no.1, pp.5-12, 2024 (Peer-Reviewed Journal) identifier

  • Publication Type: Article / Case Report
  • Volume: 11 Issue: 1
  • Publication Date: 2024
  • Doi Number: 10.22551/2024.42.1101.10278
  • Journal Name: Archieve of Clinical Cases
  • Journal Indexes: Index Copernicus, Other Indexes
  • Page Numbers: pp.5-12
  • Dokuz Eylül University Affiliated: Yes

Abstract

Toxoplasma chorioretinitis (TC) can exhibit atypical features in immunocompromised patients including bilaterality, extensive spread, multifocal presentation, large areas of retinal necrosis without adjacent retinal scarring, and diffuse necrotizing retinitis resembling the viral retinitis that may cause confusion in the differential diagnosis. The aim of this study was to present the clinical features of four eyes of three immunocompromised patients with active toxoplasma chorioretinitis. Two of the patients were female and one, male. Two patients had hematological malignancies and the remaining patient was under adalimumab treatment for ankylosing spondylitis. Visual complaints began 10 days to four months prior to TC diagnosis. All four eyes had mild-to-moderate anterior chamber cells together with severe vitritis on slit-lamp examination while there were solitary chorioretinitis lesions on fundoscopy. Despite all patients were negative for anti-toxoplasma immunoglobulin M, all were positive for immunoglobulin G. All three patients were successfully treated with a combined treatment of systemic and intravitreal anti-toxoplasmic drugs. Clinicians should be cautious for the possible toxoplasma chorioretinitis besides the other infectious entities when a new uveitis episode is detected in an immunosuppressed patient in order to avoid misdiagnosis and thereby wrong treatment.