Diagnostic approaches to severe, atypical toxoplasmosis mimicking acute retinal necrosis*1

Combined branch retinal vein and artery occlusion in toxoplasmosis

“…Atypical presentations have been reported in patients with HIV infection, iatrogenic immunosuppression, or advanced age (8) . Moshfeghi et al reported findings on 25 eyes with widespread retino choroiditis mimicking acute retinal necrosis (8) . In their cases, lesions were atypical, large, multifocal, bilateral, or associated with diffuse retinal involvement or panophthalmitis.…”

Infectious Complications in Kidney Transplantation

“…Peripheral neuropathy is common, taking a Guillain-Barré pattern in a recently reported case (Gonzalez et al, 2000). Chorioretinitis, similar to that seen in CMV infection, is frequently seen (Moshfeghi et al, 2004). Pulmonary infiltrates, with pleural involvement may occur (Barcan et al, 2002).…”

“…It is a notorious infection in intestinal transplants (Moshfeghi et al, 2004) but has also been reported as a recrudescence disease in recipients of liver (Campos et al, 2000), kidney (Minz et al, 2004), and bone marrow (Muller et al, 2004) transplants. It may cause a diarrheal illness that can lead to significant fluid and electrolyte depletion and may be fatal.…”

Intraocular Cysts ofToxoplasma gondiiin Patients with Necrotizing Retinitis following Periocular/Intraocular Triamcinolone Injection

“…Their isolation from the vitreous aspirate (as in our second case, and also reported previously 3,7 ) may suggest a more extensive necrosis of the retina, releasing the cysts into the vitreous cavity. 9 While PCR is an easier technique and preferred in certain infectious uveitis (viral) over the GoldmannWitmer coefficient (GWC), which detects intraocular antibody production, the latter has shown superior results in diagnosing ocular toxoplasmosis when compared to PCR of aqueous humor. 10 The slow release of Toxoplasma gondii tachyzoites from the cysts into the ocular fluid may explain the absence of positive PCR results in early stages.…”