Open AccessCytomegalovirus retinitis in Good syndrome: case report and review of literature
Author(s) -
Magdalena Popiela,
Mohan Varikkara,
Zachariah Koshy
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.02.2009.1576
Subject(s) - medicine , retinitis , valganciclovir , ganciclovir , chorioretinitis , cytomegalovirus , thymectomy , retinal detachment , thymoma , uveitis , cytomegalovirus retinitis , fundus (uterus) , pathology , dermatology , surgery , immunology , ophthalmology , human cytomegalovirus , retinal , herpesviridae , myasthenia gravis , virus , viral disease
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.