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AIDS-related Cryptococcus neoformans choroiditis.

Gregory S Canfield1, Sarah Reingold2,3, Andrea Ho4

  • 1Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, United States.

Idcases
|September 5, 2020
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Summary
This summary is machine-generated.

Cryptococcal choroiditis, an opportunistic fungal infection, can affect individuals with advanced HIV/AIDS. Prompt ophthalmologic examination and combination antifungal therapy are crucial for managing this rare intraocular condition.

Keywords:
ChoroiditisCryptococcalCryptococcusHIV and AIDSToxoplasma

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Immunology

Background:

  • Cryptococcal meningoencephalitis is a common opportunistic infection in patients with advanced Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS).
  • Ocular manifestations of cryptococcosis, such as choroiditis, are rare but can lead to significant visual impairment.

Observation:

  • A 29-year-old male with advanced HIV/AIDS presented with symptoms of cryptococcal and toxoplasma meningoencephalitis, including fever, photophobia, and ataxia.
  • Ophthalmologic examination revealed bilateral, multifocal posterior infiltrates indicative of cryptococcal choroiditis.

Findings:

  • The patient received a combination treatment regimen including parenteral and intravitreal liposomal amphotericin B, oral flucytosine, and oral trimethoprim-sulfamethoxazole.
  • This therapeutic approach resulted in the resolution of neurological symptoms and improvement in visual function.

Implications:

  • This case underscores the importance of comprehensive ophthalmologic evaluation in immunocompromised patients presenting with visual disturbances and invasive fungal infections.
  • Early diagnosis and multi-modal treatment are essential for managing cryptococcal choroiditis and preventing vision loss in HIV/AIDS patients.
  • The case highlights the need for increased awareness of rare opportunistic intraocular infections in the context of advanced HIV/AIDS.