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Cryptococcus choroiditis
André Luiz Land Curi National Institute of Infectious Diseases – INI/IPEC – Fiocruz Brazil
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General and Ocular History
35 year old man HIV +, CD4+: 5 cells/mm3 , viral load > Admitted due to Pneumocystis carinii pneumonia Good recovery after treatment with Bactrim® Visual loss in both eyes Vomiting , weight loss, headache
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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
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Diagnostics Admitted again Lumbar puncture Cryptococcus neoformans
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Therapy IV Amphotericin B 1 mg/kg/d for 6 weeks
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Final Visit VA : 6/9 OD 6/6 OS
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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
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