Cytomegalovirus retinitis in Good syndrome: case report and review of literature

Abstract

This report describes the case of a 59-year-old woman diagnosed with cytomegalovirus (CMV) retinitis. The diagnosis was suggested by a typical fundus appearance, and confirmed by a positive PCR for CMV of both serum and vitreous biopsy. HIV status was negative. The patient's medical history included thymoma followed by a thymectomy, recent multiple oral thrush infections, lower respiratory tract infections, urinary tract infections and severe weight loss. She had previously been treated for toxoplasma chorioretinitis and had vitrectomies for retinal detachment in the right eye. Immunological investigations revealed low T cells, almost absent B cells with reduced immunoglobulins consistent with the diagnosis of Good syndrome. The patient received treatment with intravenous ganciclovir, followed by maintenance valganciclovir, resulting in resolution of the ocular pathology. Immunoglobulin replacement therapy to boost the humoral immunity has been commenced.

Figure 1

Left eye fundus on admission.

Figure 2

Left eye fundus 3 weeks after start of virustatic therapy.