Cryptococcus choroiditis

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Presentation transcript:

Cryptococcus choroiditis André Luiz Land Curi National Institute of Infectious Diseases – INI/IPEC – Fiocruz Brazil

General and Ocular History 35 year old man HIV +, CD4+: 5 cells/mm3 , viral load >500.000 Admitted due to Pneumocystis carinii pneumonia Good recovery after treatment with Bactrim® Visual loss in both eyes Vomiting , weight loss, headache

Ocular Examination at first presentation VA : 6/18 OD / 6/60 OS No anterior chamber cells Normal intraocular pressure No vitreal cells Fundus: OU: multiple, yellowish, subretinal infiltrates FLA: hypofluorescence in early phase and hyperfluorescence in late phase corresponding to yellowish lesions

Diagnostics Admitted again Lumbar puncture Cryptococcus neoformans

Therapy IV Amphotericin B 1 mg/kg/d for 6 weeks

Final Visit VA : 6/9 OD 6/6 OS

Conclusion Multifocal choroiditis is an uncommon manifestation in disseminated Cyrptococcus neoformans infection It usually shows good response to specific therapy The diagnosis is based on latex test, direct examination and culture body fluids