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TOXOPLASMOSIS RETINOCHOROIDITIS MASQUERADING AS ENDOGENOUS ENDOPHTHALMITIS IN A CASE OF CONGENITAL LONG QT SYNDROME
Christopher R Adam1, Gary W Abrams
1Department of Ophthalmology, Visual and Anatomic Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan.
Retinal Cases & Brief Reports
|September 10, 2020
Summary
This case report details acquired toxoplasmosis retinochoroiditis in an immunocompetent patient with congenital long QT syndrome. Early diagnosis and treatment with antiparasitic medications led to successful healing of the ocular infection.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Genetics
Background:
- Ocular toxoplasmosis can present with varied clinical manifestations.
- Congenital long QT syndrome (LQTS) is a rare genetic disorder affecting cardiac repolarization.
- Endogenous endophthalmitis is a severe intraocular infection.
Observation:
- A patient with congenital LQTS developed macula-involving retinochoroiditis post-cardiac procedure, initially mimicking endophthalmitis.
- Multimodal imaging revealed a necrotizing chorioretinal lesion with vitritis and uveitis.
- Laboratory tests showed elevated toxoplasma IgG but negative infectious workup for endocarditis and other pathogens.
Findings:
- A diagnosis of presumed acquired toxoplasmosis retinochoroiditis was established.
- The patient received combined oral and intravitreal antiparasitic therapy.
- Ocular inflammation resolved, and vision improved following treatment.
Implications:
- This case highlights the diagnostic challenges of ocular toxoplasmosis mimicking endophthalmitis in immunocompetent patients with underlying conditions like LQTS.
- Multimodal imaging, thorough patient history, and specialized laboratory analysis are crucial for accurate diagnosis.
- Prompt and appropriate antitoxoplasma therapy is essential for visual recovery in atypical presentations of ocular toxoplasmosis.
