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Bilateral Placoid Choroiditis in an HIV-Positive Patient With Cryptococcus neoformans Meningitis and Disseminated

Ryan D Larochelle1, Marissa B Larochelle2, Yee Yee Aung3

  • 1Department of Ophthalmology, University of Colorado, Denver, CO, USA.

Journal of Vitreoretinal Diseases
|April 3, 2023
PubMed
Abstract

Insights

This case report details a rare instance of placoid choroiditis caused by disseminated Cryptococcus neoformans infection in an HIV-positive individual. Early identification of these ocular findings is crucial for diagnosing systemic opportunistic infections.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Mycology

Background:

  • Disseminated Cryptococcus neoformans infection can manifest with ocular complications.
  • Choroidal involvement by C. neoformans is uncommon, with placoid lesions being a rare presentation.
  • Ocular findings may precede neurological or dermatological symptoms of cryptococcosis.

Observation:

  • A 35-year-old HIV-positive male presented with disseminated cryptococcosis, including meningitis and skin lesions.
  • Ophthalmologic examination revealed bilateral placoid choroidal lesions in the posterior pole.
  • Visual acuity remained intact despite the presence of significant choroidal pathology.

Findings:

  • The case presents a presumptive diagnosis of bilateral placoid choroiditis secondary to disseminated Cryptococcus neoformans.
  • This represents an unusual variant of multifocal choroiditis caused by C. neoformans.
  • Differential diagnosis must exclude other infectious etiologies like choroidal tuberculosis.

Implications:

  • Placoid choroidal lesions in HIV-positive patients warrant investigation for systemic, life-threatening opportunistic infections.
  • Early recognition of ocular cryptococcosis can aid in the timely diagnosis and management of disseminated disease.
  • This case highlights the importance of a comprehensive ophthalmologic evaluation in immunocompromised patients with suspected systemic infections.
Keywords:
AIDSCryptococcus neoformansHIVchoroiditisimmunocompromiseduveitis

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