Which clinical history findings are characteristic of toxoplasma retinochoroiditis in HIV infection?

Updated: Jul 21, 2021
  • Author: Luca Rosignoli, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Transplacental infection resulting in toxoplasma chorioretinitis occurs in 20% of pregnancies with active maternal infection. The severity of the fetal infection depends on the stage of pregnancy. In the first trimester, toxoplasmosis can result in abortion or in an infant with chorioretinitis, encephalitis with associated intracerebral calcification, hydrocephalus, and mental retardation.

Ocular manifestation often consists of bilateral chorioretinitis in the posterior pole, particularly in the macula region. Ocular manifestation may become evident during or shortly after a systemic infection, or months to years later.

The usual ocular lesion of toxoplasmosis is a focal necrotizing retinitis, with white infiltration and surrounding retinal edema. Anterior segment uveitis, with keratic precipitates and anterior chamber cells and flare, is common. The areas of retinitis may be single or multiple, small or large, and frequently are adjacent to inactive chorioretinal scars. Optic disc swelling, neuroretinitis, mild granulomatous iritis, localized vasculitis, and retinal artery or vein occlusion in the area of the inflammation may be present. In immunosuppressed patients, the inflammatory reaction in the choroid, retina and vitreous tends to be milder than in immunocompetent patients.

Vitreous precipitates on the posterior surface of the detached vitreous may be present. Occasionally, a chorioretinal scar may be seen in the uninvolved eye.


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