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Case Reports
. 2011 Aug;17(8):CS99-102.
doi: 10.12659/msm.881890.

Bilateral acute retinal necrosis associated with neuroinfection in patient after renal transplantation

Joanna Brydak-Godowska  1 , Szymon Szczepanik, Michal Ciszek, Dominika Bialas, Miroslaw Grzeszczyk, Dariusz Strzeleck, Dariusz Kecik
Affiliations
Case Reports

Bilateral acute retinal necrosis associated with neuroinfection in patient after renal transplantation

Joanna Brydak-Godowska et al. Med Sci Monit. 2011 Aug.

Abstract

Background: Acute retinal necrosis (ARN) is characterized by the triad of acute vitritis, peripheral necrotizing retinitis and vasculitis.

Case report: We report a case of 54-year-old woman with bilateral acute retinal necrosis associated with neuroinfection. Her past medical history included renal transplantation, hypertension and aortic stenosis. Observational case report: Diagnostic investigations included biochemical tests, lumbar puncture, eye ultrasonography and MRI of the brain. Anti-HSV IgG antibody titers were elevated in the blood and cerebrospinal fluid. In MRI T2-mode, inflammatory changes were found in the white matter of the right hemisphere. The patient was treated with systemic acyclovir, itraconazole, metronidazole and ciprofloxacin for 3 weeks. Retinal detachment was observed in both eyes.

Conclusions: Acute retinal necrosis can be the single manifestation of herpes virus reactivation in patients after organ transplantation.

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Figures

Figure 1
Figure 1
Peripheral focus of retinal necrosis in the course of healing.
Figure 2
Figure 2
Primary retinal detachment involving the entire retina in the right eye in ultrasound scan.
Figure 3
Figure 3
Focus of inflammation in the central nervous system seen in NMR scan.
See this image and copyright information in PMC

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