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BMJ Case Reports 2012; doi:10.1136/bcr.12.2011.5419
  • Reminder of important clinical lesson

Atypical toxoplasmic retinochoroiditis

  1. Baljean Dhillon1
  1. 1Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, UK
  2. 2Department of Microbiology, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Professor Baljean Dhillon, Bal.Dhillon{at}luht.scot.nhs.uk

Summary

We report a case of re-activation of Toxoplasma gondii as a cause of atypical retinal necrosis in an immunocompetent individual. The rapid development of necrotising confluent retinochoroiditis and vitreous inflammation necessitated urgent aqueous humor PCR analysis, which was positive for T gondii. The patient was treated with two intravitreal injections of clindamycin, along with oral sulphadiazine, pyrimethamine, folinic acid and prednisolone. He developed central retinal arterial occlusion, as a complication of toxoplasmic retinochoroiditis, and immediate anterior chamber paracentesis was performed with visual recovery. The injection of intravitreal clindamycin with concomitant oral therapy was associated with control of toxoplasmic retinochoroiditis and resolution of vitreous inflammation.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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