[Posterior retinal hole secondary to a candida retinitis]. / Agujero retiniano en polo posterior secundario a un foco de retinitis por cándida.

CASE REPORT: We describe the case of a 36-year-old man with a history of intravenous heroin use, who was HIV negative. Left ocular examination disclosed a focal candida retinitis in the posterior pole associated with vitritis and moderate iritis. Treatment with fluconazole inactived the chorio-retinal lesion and resolved the vitritis, but developed an inner limiting membrane contraction over the macula. Two years later, vitreous traction produced a retinal hole that needed argon laser photocoagulation. DISCUSSION: Candida retinitis which penetrates into the vitreous cavity can produce retinal holes by vitreous traction over the lesion.

Trastorno obsesivo psicótico en la adolescencia / Obsessive-compulsive disorder with psychotic features in adolescence

La relación entre el trastorno obsesivo-compulsivo (TOC) y la patología psicótica es controvertida. Los informes clínicos indican que el TOC psicótico suele tener mayor gravedad y peor respuesta al tratamiento con antidepresivos que el TOC neurótico. El tratamiento conductual se ha mostrado ineficaz en TOC psicótico. Uno de los subtipos de TOC psicótico incluye los estados paranoides reactivos, propios de pacientes obsesivos que presentan ideas delirantes que responden bien añadiendo neurolépticos a los inhibidores de la recaptación de serotonina (IRS) usados en el TOC. Presentamos el caso de una mujer de 17 años con historia familiar de TOC, que desarrolla un cuadro de pánico tras tomar cannabis, que cristaliza rápidamente en un TOC con conductas evitativas e ideas delirantes de referencia y perjuicio. Analizamos la respuesta al tratamiento conductual, IRS y neurolépticos. (AU)

[Obsessive psychotic disorder in adolescence]. / Trastorno obsesivo psicótico en la adolescencia.

Relationship between obsessive-compulsive disorder (OCD) and psychotic pathology is a controversial one. Case reports indicate that OCD with psychotic features is generally more severe and antidepressant-refractory than neurotic OCD. Behaviour therapy is shown to be ineffective in OCD patients with psychotic features. One of the subtypes includes reactive paranoid forms, with fluctuating clinical course, in obsessive patients with delusional thoughts that improve with neuroleptic augmentation of the serotonin reuptake inhibitor (SRI) treatment for OCD. We present the case of a 17-year-old woman with family history of OCD, starting with panic symptoms after cannabis use, but suddenly developing OCD with avoidant behavior and delusional ideas of self-reference and persecution. Response to behavior therapy and SRI and neuroleptics is analyzed.