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Published byDerick Hawkins Modified over 8 years ago
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Cryptococcus neoformans Choroiditis Rupesh Agrawal, Ho Su Ling, Stephen Teoh Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore
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46 year old Chinese gentleman. 46 year old Chinese gentleman. Known HIV Known HIV s/p OD: CMV retinitis –treated with intravitreal ganciclovir s/p OD: CMV retinitis –treated with intravitreal ganciclovir OS- presented with blurring of vision OS- presented with blurring of vision Ocular and General History - Case A LE: Fundus– presence of choroiditis patch superotemporal to fovea
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45 year old Chinese gentleman 45 year old Chinese gentleman Known HIV. Known HIV. Sudden onset blurring of vision Sudden onset blurring of vision BCVA – 6/12 OU BCVA – 6/12 OU OD: composite fundus photo OD: composite fundus photo showing presence of hyperemic disc with peripapillary hemmorrhages Ocular and General History - Case B
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44 year old Chinese Male. 44 year old Chinese Male. Known HIV Known HIV Acute onset blurring of vision both eyes Acute onset blurring of vision both eyes Both eyes – exudative retinal detachment with hyperemic disc Both eyes – exudative retinal detachment with hyperemic disc Ocular and General History - Case C
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All three patients C. Neoformans opportunistic infection – positive titres on lumbar puncture at a dilution of 1:256. First Presentation - Investigations
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Cryptococcus induced chorioretinitis with AIDS based on serology clinical findings history (HIV) Diagnosis
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IV Amphotericin: 1mg/kg/day for 7 days Oral Fluconazole: 800mg OD x 2weeks 400mg OD x 8 weeks HAART therapy Treatment
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Last Follow up – After 6 Months Post Treatment OD: no active lesions, pallor of disc
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