ABSTRACT
PURPOSE: We assessed the frequency of panophthalmitis in HIV-infected patients. MATERIALS AND METHODS: Thirty-seven cases of panophthalmitis were screened out of 420 hospitalized patients of ophthalmology department of Cocody Teaching University Hospital, Abidjan, Ivory Coast, from January to October 1995. HIV-tests were performed in 11 patients. RESULTS: Mean age was 40 years (from 10 months to 75 years). Four patients (36.4% of tested patients) were infected by HIV. Contrary to seronegative patients, panophthalmitis cases in HIV-infected patients occurred spontaneously without any apparent exogenous cause (foreign bodies). Most of patients were young (from 18 to 47 years old). CONCLUSION: We draw the attention of eye specialists of the frequency of panophthalmitis without exogenous apparent cause in HIV patients. It would be interesting to perform a transvitreal needle biopsy in order to search for intraocular toxoplasmosis that should be the first cause.
Subject(s)
HIV Infections/epidemiology , Panophthalmitis/epidemiology , AIDS Serodiagnosis , AIDS-Related Opportunistic Infections/epidemiology , AIDS-Related Opportunistic Infections/parasitology , Adolescent , Adult , Child , Child, Preschool , Comorbidity , Cote d'Ivoire/epidemiology , Eye Foreign Bodies/complications , Eye Foreign Bodies/epidemiology , Female , HIV Infections/complications , HIV Seronegativity , Humans , Incidence , Infant , Male , Middle Aged , Panophthalmitis/etiology , Panophthalmitis/microbiology , Panophthalmitis/parasitology , Staphylococcal Infections/complications , Staphylococcal Infections/epidemiology , Toxoplasmosis, Ocular/complications , Toxoplasmosis, Ocular/epidemiologyABSTRACT
We studied two patients, a 43-year-old Hispanic man with a one-year history of acquired immunodeficiency syndrome (AIDS) and a 34-year-old Hispanic man with newly diagnosed AIDS. Both had necrotizing retinitis that progressed to panophthalmitis and orbital cellulitis. Toxoplasmosis was not diagnosed in the first patient early in the course of the disease. The second patient had a history of toxoplasmic retinochoroiditis. Despite anti-toxoplasmosis therapy, visual acuity deteriorated to no light perception in both patients. Diagnostic biopsy of the eye wall was performed on the first patient and enucleation of the globe on the second. Toxoplasmic panophthalmitis and orbital cellulitis were diagnosed in each patient by light microscopy and confirmed by electron microscopy. When patients with AIDS develop necrotizing retinitis, toxoplasmosis must be considered in the differential diagnosis, along with cytomegalovirus retinitis, progressive outer retinal necrosis, and syphilitic retinitis. Unlike cytomegalovirus retinitis, progressive outer retinal necrosis, and syphilitic retinitis, however, toxoplasmosis can cause a progressive intraocular infection, panophthalmitis, and orbital cellulitis in patients with AIDS.
