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56 year old man The patient has a new cotton wool spot with hemorrhage in the left eye. There is a blur superiorly in the left eye.  He has a history of high blood pressure.  BP 162/98 VA OD: sc20/63 PH20/32 NccJ3 VA OS: Dcc20/25 NccJ16 IOP: TP: OD:23 OS:18 NEGATIVE: Posterior retinitis Patient started on Bactrim BID, Valtrex 1000 mg TID Anterior Chamber Tap negative for VZV,HSV,CMV, and Toxoplasmosis ACE, Lysozyme, CXR, RPR, FTA-ABS negative Lyme, CBC, CMP, UA negative ANA had turned positive Brain MRI normal Management: Intravitreal Gancyclovir Given (possible CMV) Vision started to improve within one week: 2/11/20 – presentation – 20/25 2/18/20 – 4/200 2/20/20 – 4/200 2/21/20 – 4/200 – IV Gancyclovir Given 2/25/20 – 20/63 lesion smaller – less edema 2/28/20 – 20/32 A TEST CAME BACK POSITIVE Toxoplasmosis IgM > 160 (negative < 8.0) IgG > 400 (negative < 6.0) 30% of the world population is infected with toxoplasmosis 1/3 congenital 2/3 acquired North America – 10% - 30% prevalence Latin America – 60% prevalence Definitive host – cats Intermediate host – mammals Transmission: Cat feces Undercooked meat with tissue cysts Infection during pregnancy  fetal transmission Recurrence rate 5 years: 79% Recurrence less common in treated patients Management 4-6 weeks (randomized study showed equivalent): Pyrimethamine, sulfadiazine, steroids Clindamycin, sulfadiazine, steroids Bactrim, steroids

toxo_stmor1_021120_01.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption3 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_04.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption3 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_03.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption3 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_02.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_07.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_06.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_08.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_09.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_05.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_10.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_11.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_13.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_14.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_12.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_15.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_16.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_17.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_19.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_18.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_20.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_22.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_21.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_23.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_25.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_24.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_27.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_26.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_28.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_29.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_30.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor1_021120_31.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_23.png
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_24.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_25.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_28.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_27.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_26.JPG
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_29.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_30.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_31.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_32.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_34.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor2_022020_33.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor4_032720_37.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor4_032720_38.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption2 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor5_VF39.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption3 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor3_allimages35.png
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption5 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor5_VF40.jpg
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption5 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
toxo_stmor3_allimages36.png
Acquired Toxoplasmosis Retinitis Para Foveal - Following Venison Consumption7 views56 year old man who became very sick after eating venison at the end of December 2019. Presented 6 weeks later with a scotoma. Initial photos show presentation with 20/63 vision. Vision dropped to 5/200. All tests (including PCR of anterior chamber tap) were negative except serum toxoplasmosis IgG and IgM. Vision improved to 20/32 but the scotoma remained on oral trimetheprim/sulfa00000
(0 votes)
     
49 files on 1 page(s)

56 year old man The patient has a new cotton wool spot with hemorrhage in the left eye. There is a blur superiorly in the left eye.  He has a history of high blood pressure.  BP 162/98 VA OD: sc20/63 PH20/32 NccJ3 VA OS: Dcc20/25 NccJ16 IOP: TP: OD:23 OS:18 NEGATIVE: Posterior retinitis Patient started on Bactrim BID, Valtrex 1000 mg TID Anterior Chamber Tap negative for VZV,HSV,CMV, and Toxoplasmosis ACE, Lysozyme, CXR, RPR, FTA-ABS negative Lyme, CBC, CMP, UA negative ANA had turned positive Brain MRI normal Management: Intravitreal Gancyclovir Given (possible CMV) Vision started to improve within one week: 2/11/20 – presentation – 20/25 2/18/20 – 4/200 2/20/20 – 4/200 2/21/20 – 4/200 – IV Gancyclovir Given 2/25/20 – 20/63 lesion smaller – less edema 2/28/20 – 20/32 A TEST CAME BACK POSITIVE Toxoplasmosis IgM > 160 (negative < 8.0) IgG > 400 (negative < 6.0) 30% of the world population is infected with toxoplasmosis 1/3 congenital 2/3 acquired North America – 10% - 30% prevalence Latin America – 60% prevalence Definitive host – cats Intermediate host – mammals Transmission: Cat feces Undercooked meat with tissue cysts Infection during pregnancy  fetal transmission Recurrence rate 5 years: 79% Recurrence less common in treated patients Management 4-6 weeks (randomized study showed equivalent): Pyrimethamine, sulfadiazine, steroids Clindamycin, sulfadiazine, steroids Bactrim, steroids