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January 26, 1994

Ocular ToxoplasmosisAn Old Disease Revisited

Author Affiliations

From the Laboratory of Immunology, National Eye Institute, Bethesda, Md (Dr Nussenblatt), and the Department of Ophthalmology, Escola Paulista de Medicina-Hospital São Paulo, São Paulo, Brazil (Dr Belfort).

JAMA. 1994;271(4):304-307. doi:10.1001/jama.1994.03510280066035


Case 1  A 20-year-old man was seen in 1989 after 10 days of decreasing vision in the right eye. Four months previously, he had lost weight and had lymphadenopathy and fever, which lasted about 4 days. Ocular examination showed poor vision in the right eye (20/200), vitreal cells, and a focal necrotizing retinochoroiditis in the macula. His antitoxoplasmosis immunoglobulin M (IgM) and immunoglobulin G (IgG) titers were 1:256 and 1:32 000. He was treated with pyrimethamine, sulfadiazine, and prednisone, with a resolution of the lesion's activity. He was left with a scar in the macula, and his vision improved to 20/40. In 1991, he developed a small satellite lesion close to the original one and was retreated. His IgG titer was 1:512, and the IgM titer was negative.

Case 2  In 1978, a 2-year-old boy living in southern Brazil developed a fever that lasted for 3 weeks. Systemic

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