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題 名 | Diffuse Toxoplasmic Retinochoroiditis as the Initial Manifestation of Acquired Immunodeficiency Syndrome=以彌漫性弓漿原蟲視網膜脈絡膜炎為初發症狀之後天免疫不全症候群 |
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作 者 | 李怡芬; 陳世真; 張由美; 劉榮宏; 王永衛; | 書刊名 | 臺灣醫學會雜誌 |
卷 期 | 99:3 2000.03[民89.03] |
頁 次 | 頁219-223 |
分類號 | 416.746 |
關鍵詞 | 彌漫性弓漿原蟲視網膜脈絡膜炎; 後天免疫不全症候群; Toxoplasmosis; Diffuse necrotizing retinochoroiditis; Acquired immunodeficiency syndrome; |
語 文 | 英文(English) |
英文摘要 | Toxoplasmic retinochoroiditis is an important opportunistic retinal infection in human immunodeficiency virus (HIV)-infected patients. It may present as diffuse necrotizing retinochoroiditis instead of a focal lesion and may be the initial manifestation of HIV infection. A 50-year-old heterosexual man presented with blurred vision in his left eye of 3 months' duration. Fundus examination revealed diffuse necrotizing retinochoroiditis, mainly at the posterior pole, with marked vitritis in the left eye. Serologic studies and aqueous fluid antibody titers indicated recent toxoplasmic infection. Positive enzyme immunoassays (EIA) and Western blot tests proved HIV infection. The retinochoroiditis and vitritis improved after an antitoxoplasmic regimen with trimethoprim-sulfamethoxazole (TMP-SMX). Nonetheless, toxoplasmic encephalitis developed 6 months after the onset of ocular toxoplasmosis and responded well to TMP-SMX. This is the first case of toxoplasmic retinochoroiditis as the initial manifestation of AIDS reported in Taiwan. We suggest that Toxoplasma infection should be included in the differential diagnosis of diffuse necrotizing retinochoroiditis and vitritis. We also recommend that adults with newly diagnosed ocular toxoplasmosis be screened for HIV infection. |
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