Multifocal choroiditis with panuveitis in a patient with disseminated Mycobacterium avium complex

Retin Cases Brief Rep. 2013 Spring;7(2):155-7. doi: 10.1097/ICB.0b013e3182790ef9.

Abstract

Purpose: The authors present a case of multifocal choroiditis and panuveitis secondary to disseminated Mycobacterium avium complex infection in a patient with human immunodeficiency virus/AIDS.

Method: Case report and review of relevant literature.

Results: A 48-year-old woman with human immunodeficiency virus was admitted for the work up of abdominal pain, fevers, and weight loss. She was noncompliant with antiretroviral therapy with a CD4 count of 30 × 10/L. She reported bilateral reduction in vision with corrected acuities of 6/18 in the right eye and 6/36 in the left eye. Bilateral granulomatous panuveitis with multifocal choroiditis was present. A vitreous biopsy of the left eye confirmed Mycobacterium avium complex, also identified on mycobacterium blood cultures. She was started on oral azithromycin and ethambutol, and after 6 months, her corrected acuities were 6/9 in the right eye bilaterally with an improvement in uveitis and choroiditis.

Conclusion: Mycobacterium avium complex infection should be considered as a cause of visual impairment in patients with human immunodeficiency virus/AIDS. Early detection and prompt management are essential for the prevention of visual and other systemic complications.