RT Journal Article
SR Electronic
T1 Progressive outer retinal necrosis: manifestation of human immunodeficiency virus infection
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2014207344
DO 10.1136/bcr-2014-207344
VO 2015
A1 Phey Feng Lo
A1 Rongxuan Lim
A1 Serafeim N Antonakis
A1 Goncalo C Almeida
YR 2015
UL http://casereports.bmj.com/content/2015/bcr-2014-207344.abstract
AB We present the case of a 54-year-old man who developed progressive outer retinal necrosis (PORN) as an initial manifestation of HIV infection without any significant risk factors for infection with HIV. PORN is usually found as a manifestation of known AIDS late in the disease. Our patient presented with transient visual loss followed by decrease in visual acuity and facial rash. Subsequent investigation revealed anterior chamber tap positive for varicella zoster virus (VZV), as well as HIV positivity, with an initial CD4 count of 48 cells/µL. Systemic and intravitreal antivirals against VZV, and highly active antiretroviral therapy against HIV were started, which halted further progression of retinal necrosis. This case highlights the importance of suspecting PORN where there is a rapidly progressive retinitis, and also testing the patient for HIV, so appropriate treatment can be started.