Immune-Recovery Posterior Uveitis Associated With Inactive Isolated Toxoplasmic Retinochoroiditis in a Patient With Human Immunodeficiency Virus

In Brief Purpose: To report a case of severe panuveitis in a patient with human immunodeficiency virus that developed after inactivation of toxoplasmic retinochoroiditis. The patient also developed cerebral toxoplasmosis. Methods: A patient with human immunodeficiency virus who developed immune-recovery posterior uveitis in the context of inactive toxoplasmic retinochoroiditis underwent complete ophthalmologic evaluation, polymerase chain reaction of the aqueous humor, diagnostic vitrectomy, and cerebral ancillary testing. Results: Polymerase chain reaction–confirmed toxoplasmic retinochoroiditis healed with appropriate treatment, but 2 months later coinciding with systemic immune restoration, the brain lesions worsened and immune-recovery panuveitis caused decreased visual acuity. Diagnostic vitrectomy confirmed only inflammatory cells. Conclusion: Immune-recovery panuveitis caused by cytomegalovirus retinitis is well documented, but we found only one published case caused by toxoplasma. Immune-recovery panuveitis should not be ruled out despite the absence of previous cytomegalovirus retinitis. A patient with human immunodeficiency virus who has had an intraocular opportunistic infection, despite resolution, must be followed-up by an ophthalmologist in collaboration with an infectious disease specialist to prevent blindness. Immune-recovery panuveitis caused by cytomegalovirus retinitis is well documented, but we found only one published case caused by toxoplasma. Immune-recovery panuveitis should not be ruled out despite the absence of previous cytomegalovirus retinitis. A patient with human immunodeficiency virus who has had an intraocular opportunistic infection, despite resolution, must be followed-up by an ophthalmologist in collaboration with an infectious disease specialist to prevent blindness.