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Acquired toxoplasmic retinitis in an immunosuppressed patient: diagnosis by transvitreal fine-needle aspiration biopsy

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Abstract

Background

Acquired multifocal white retinal lesions in an immunosuppressed patient are diagnostically challenging.

Methods

Case report of a 34-year-old woman who underwent bone marrow transplantation for chronic myelogenous leukemia. Four months after the transplant, while on relatively high doses of immunosuppressive drugs, she developed bilateral multifocal retinitis versus leukemic retinal infiltration. Fine-needle aspiration biopsy was performed on one eye in an attempt to establish a cytological diagnosis.

Results

The aspirate was found to contain individual crescent-shaped intraretinal organisms and cysts, consistent with the diagnosis of toxoplasmic retinitis. The patient was started immediately on an anti-toxoplasmosis regimen consisting of sulfadiazine, pyrimethamine, and folinic acid. Follow-up examinations revealed complete inactivation of the retinitis and no delayed complications of the biopsy.

Conclusion

Fine-needle aspiration biopsy can be a useful diagnostic tool in selected patients with acquired retinal infiltrates.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Cincinnati College of Medicine, 260 Stetson Street, Suite 5300, P.O. Box 670527, Cincinnati, OH, 45267–0527, USA

    Elizabeth M. Palkovacs, Zelia Correa & James J. Augsburger

  2. Department of Ophthalmic Pathology, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Ralph C. Eagle Jr.

Authors
  1. Elizabeth M. Palkovacs
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  2. Zelia Correa
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  3. James J. Augsburger
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  4. Ralph C. Eagle Jr.
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Corresponding author

Correspondence to Zelia Correa.

Additional information

Summary Statement: Fine-needle aspiration biopsy was used to diagnose toxoplasmic retinitis in an immunosuppressed patient.

Support: This work was supported in part by a Departmental Challenge grant from Research to Prevent Blindness, Inc., New York, New York, to the Department of Ophthalmology, University of Cincinnati College of Medicine (James J. Augsburger, Chairman), and the Research and Education Fund of the Department of Ophthalmology, University of Cincinnati College of Medicine.

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Palkovacs, E.M., Correa, Z., Augsburger, J.J. et al. Acquired toxoplasmic retinitis in an immunosuppressed patient: diagnosis by transvitreal fine-needle aspiration biopsy. Graefes Arch Clin Exp Ophthalmol 246, 1495–1497 (2008). https://doi.org/10.1007/s00417-008-0838-z

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  • DOI: https://doi.org/10.1007/s00417-008-0838-z

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