Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2013 Apr 9:2013:bcr2013008962.
doi: 10.1136/bcr-2013-008962.

The absence of vitreous inflammation: one more challenge in diagnosing toxoplasma papillitis

Michael Adly Mikhail  1 , Mohan Varikkara
Affiliations
Case Reports

The absence of vitreous inflammation: one more challenge in diagnosing toxoplasma papillitis

Michael Adly Mikhail et al. BMJ Case Rep. .

Abstract

Toxoplasma is a leading cause of posterior uveitis in immunocompetent patients manifesting as a focal posterior retinochoroiditis. The clinical diagnosis of ocular toxoplasmosis is usually straightforward. There is typically a fluffy white retinal lesion which may lie adjacent to a pigmented chorioretinal scar and a prominent vitreous, or additionally, anterior chamber cellular reaction. Several unusual presentations in ocular toxoplasmosis have been reported, including: papillitis, neuroretinitis, retrobulbar neuritis, retinal detachment and macular oedema. This is a case of presumed primary toxoplasma papillitis in a 14-year-old child with complete absence of vitritis at presentation that made the diagnosis challenging. This evolved into neuroretinitis that resolved upon introducing antitoxoplasma antibiotics.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Grossly swollen optic nerve head with a focus of a fluffy white lesion on the inferotemporal margin.
Figure 2
Figure 2
New appearance of incomplete macular star suggesting neuroretinitis.
Figure 3
Figure 3
Complete resolution of the retinitis with a pigmented scar. The macular star resolved with retinal pigment epithelial changes.
See this image and copyright information in PMC

References

    1. Folk JC, Lobes LA. Presumed toxoplasmic papillitis. Ophthalmology 1984;2013:64–7 - PubMed
    1. Fish RH, Hoskins JC, Kline LB. Toxoplasma neuroretinitis. Ophthalmology 1993;2013:1177–82 - PubMed
    1. Rahi A, Tabarra K. Laboratory investigations in posterior uveitis. Int Ophthalmol Clin 1995;2013:65–6 - PubMed
    1. Garweg JG, de Groot-Mijnes JD, Montoya JG. Diagnostic approach to ocular toxoplasmosis. Ocul Immunol Inflamm 2011;2013:456 - PMC - PubMed
    1. De Groot-Mijnes JD, Rothova A, Van Loon AM, et al. Polymerase chain reaction and Goldmann-Witmer coefficient analysis are complimentary for the diagnosis of infectious uveitis. Am J Ophthalmol 2006;2013:313–18 - PubMed

Publication types