Uncommon progression of toxoplasmic papillitis: patient perception and case report

Detalhes bibliográficos
Autor(a) principal: Bonamigo,Elcio Luiz
Data de Publicação: 2021
Outros Autores: Rossi,Eglas Emanuel, Rosa,Maria do Carmo Nunes da, Stock,Ricardo Alexandre, Sampaio,Rodrigo Rosa, Lora,Ronei Carlos
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Revista Brasileira de Oftalmologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802021000500503
Resumo: ABSTRACT Ocular toxoplasmosis frequently presents as necrotizing retinochoroiditis and, less often, as peripapillary chorioretinitis and/or papillitis. The progression from papillitis to peripapillary retinochoroiditis has been rarely described. We report the case of a 52-year-old patient living in southern Brazil, who developed papillitis in the right eye and was treated with systemic corticosteroids (prednisone 0.6 mg/kg/day and pulse therapy with methylprednisolone 15 mg/kg/day, for 3 days). After 14 days, the patient developed peripapillary retinochoroiditis with vitritis and decreased visual acuity (20/60), and was immediately initiated on the classic oral treatment for toxoplasmosis, consisting of pyrimethamine (50 mg/day), sulfadiazine (4 g/day), folinic acid (15 mg every 3 days) and prednisone (0.6 mg/kg/day). The visual acuity of the right eye normalized after treatment (20/20), which lasted approximately 70 days, but scotomas were detected on visual field examination, especially in the lower nasal quadrant. Although two studies mentioned this presentation, our report emphasizes the possible manifestation of ocular toxoplasmosis as papillitis in the initial phase, with progression to peripapillary retinochoroiditis and permanent visual field defects, which justifies early treatment for toxoplasmosis in suspected cases, especially in endemic regions.
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spelling Uncommon progression of toxoplasmic papillitis: patient perception and case reportToxoplasmosis, ocularPapilledemaChoroiditisDrug-related side effects and adverse reactionsABSTRACT Ocular toxoplasmosis frequently presents as necrotizing retinochoroiditis and, less often, as peripapillary chorioretinitis and/or papillitis. The progression from papillitis to peripapillary retinochoroiditis has been rarely described. We report the case of a 52-year-old patient living in southern Brazil, who developed papillitis in the right eye and was treated with systemic corticosteroids (prednisone 0.6 mg/kg/day and pulse therapy with methylprednisolone 15 mg/kg/day, for 3 days). After 14 days, the patient developed peripapillary retinochoroiditis with vitritis and decreased visual acuity (20/60), and was immediately initiated on the classic oral treatment for toxoplasmosis, consisting of pyrimethamine (50 mg/day), sulfadiazine (4 g/day), folinic acid (15 mg every 3 days) and prednisone (0.6 mg/kg/day). The visual acuity of the right eye normalized after treatment (20/20), which lasted approximately 70 days, but scotomas were detected on visual field examination, especially in the lower nasal quadrant. Although two studies mentioned this presentation, our report emphasizes the possible manifestation of ocular toxoplasmosis as papillitis in the initial phase, with progression to peripapillary retinochoroiditis and permanent visual field defects, which justifies early treatment for toxoplasmosis in suspected cases, especially in endemic regions.Sociedade Brasileira de Oftalmologia2021-01-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802021000500503Revista Brasileira de Oftalmologia v.80 n.5 2021reponame:Revista Brasileira de Oftalmologia (Online)instname:Sociedade Brasileira de Oftalmologia (SBO)instacron:SBO10.37039/1982.8551.20210036info:eu-repo/semantics/openAccessBonamigo,Elcio LuizRossi,Eglas EmanuelRosa,Maria do Carmo Nunes daStock,Ricardo AlexandreSampaio,Rodrigo RosaLora,Ronei Carloseng2021-09-24T00:00:00Zoai:scielo:S0034-72802021000500503Revistahttps://rbo.emnuvens.com.br/rbo/indexhttps://old.scielo.br/oai/scielo-oai.phpsob@sboportal.org.br||rbo@sboportal.org.br1982-85510034-7280opendoar:2021-09-24T00:00Revista Brasileira de Oftalmologia (Online) - Sociedade Brasileira de Oftalmologia (SBO)false
dc.title.none.fl_str_mv Uncommon progression of toxoplasmic papillitis: patient perception and case report
title Uncommon progression of toxoplasmic papillitis: patient perception and case report
spellingShingle Uncommon progression of toxoplasmic papillitis: patient perception and case report
Bonamigo,Elcio Luiz
Toxoplasmosis, ocular
Papilledema
Choroiditis
Drug-related side effects and adverse reactions
title_short Uncommon progression of toxoplasmic papillitis: patient perception and case report
title_full Uncommon progression of toxoplasmic papillitis: patient perception and case report
title_fullStr Uncommon progression of toxoplasmic papillitis: patient perception and case report
title_full_unstemmed Uncommon progression of toxoplasmic papillitis: patient perception and case report
title_sort Uncommon progression of toxoplasmic papillitis: patient perception and case report
author Bonamigo,Elcio Luiz
author_facet Bonamigo,Elcio Luiz
Rossi,Eglas Emanuel
Rosa,Maria do Carmo Nunes da
Stock,Ricardo Alexandre
Sampaio,Rodrigo Rosa
Lora,Ronei Carlos
author_role author
author2 Rossi,Eglas Emanuel
Rosa,Maria do Carmo Nunes da
Stock,Ricardo Alexandre
Sampaio,Rodrigo Rosa
Lora,Ronei Carlos
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Bonamigo,Elcio Luiz
Rossi,Eglas Emanuel
Rosa,Maria do Carmo Nunes da
Stock,Ricardo Alexandre
Sampaio,Rodrigo Rosa
Lora,Ronei Carlos
dc.subject.por.fl_str_mv Toxoplasmosis, ocular
Papilledema
Choroiditis
Drug-related side effects and adverse reactions
topic Toxoplasmosis, ocular
Papilledema
Choroiditis
Drug-related side effects and adverse reactions
description ABSTRACT Ocular toxoplasmosis frequently presents as necrotizing retinochoroiditis and, less often, as peripapillary chorioretinitis and/or papillitis. The progression from papillitis to peripapillary retinochoroiditis has been rarely described. We report the case of a 52-year-old patient living in southern Brazil, who developed papillitis in the right eye and was treated with systemic corticosteroids (prednisone 0.6 mg/kg/day and pulse therapy with methylprednisolone 15 mg/kg/day, for 3 days). After 14 days, the patient developed peripapillary retinochoroiditis with vitritis and decreased visual acuity (20/60), and was immediately initiated on the classic oral treatment for toxoplasmosis, consisting of pyrimethamine (50 mg/day), sulfadiazine (4 g/day), folinic acid (15 mg every 3 days) and prednisone (0.6 mg/kg/day). The visual acuity of the right eye normalized after treatment (20/20), which lasted approximately 70 days, but scotomas were detected on visual field examination, especially in the lower nasal quadrant. Although two studies mentioned this presentation, our report emphasizes the possible manifestation of ocular toxoplasmosis as papillitis in the initial phase, with progression to peripapillary retinochoroiditis and permanent visual field defects, which justifies early treatment for toxoplasmosis in suspected cases, especially in endemic regions.
publishDate 2021
dc.date.none.fl_str_mv 2021-01-01
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.37039/1982.8551.20210036
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Oftalmologia
publisher.none.fl_str_mv Sociedade Brasileira de Oftalmologia
dc.source.none.fl_str_mv Revista Brasileira de Oftalmologia v.80 n.5 2021
reponame:Revista Brasileira de Oftalmologia (Online)
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