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Fulminant Toxoplasmic Chorioretinitis Following Intravitreal Dexamethasone Implantation
유리체강 내 덱사메타손임플란트삽입술 후 발생한 전격 톡소플라즈마 맥락망막염
JKOS 2019 Sep;60(9):896-900
Published online September 15, 2019;  https://doi.org/10.3341/jkos.2019.60.9.896
Copyright © 2019 The Korean Ophthalmological Society.
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Areum Jeong, MD, Dong-Geun Park, MD, Min Sagong, MD, PhD
정아름 · 박동근 · 사공민

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
영남대학교 의과대학 안과학교실
Received January 10, 2019; Revised March 17, 2019; Accepted August 16, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: To report a case of fulminant toxoplasmic chorioretinitis following intravitreal dexamethasone implantation monotherapy in a stabilized toxoplasmic chorioretinitis patient with initial treatment.
Case summary: A 60-year-old healthy female presented with decreased visual acuity in the left eye. On fundus examination, focal chorioretinitis and yellow-white infiltration were observed. Laboratory work-up, including blood chemistry, complete blood count, and serum serology, was negative; however, toxoplasmic chorioretinitis could not be ruled out. The primary lesion improved with antibiotics and prednisolone treatment. However, the patient did not come in for her follow-up visit, as she had already received an intravitreal dexamethasone implant for recurrent vitreous inflammation elsewhere. On her return, she presented with necrotic retinitis with extensive infiltration. She underwent diagnostic vitrectomy and implant removal. A diagnosis of toxoplasma antigen was confirmed by polymerase chain reaction analysis; the lesions stabilized after anti-toxoplasmic therapy.
Conclusions: Intravitreal dexamethasone implant monotherapy with stabilized toxoplasmic chorioretinitis without systemic antibiotics can lead to fulminant toxoplasmic chorioretinitis and should be used with caution.
Keywords : Dexamethasone implant, Intravitreal injection, Toxoplasma gondii, Toxoplasmic chorioretinitis, Toxoplasmosis

 

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