Immune-recovery posterior uveitis associated with inactive isolated toxoplasmic retinochoroiditis in a patient with human immunodeficiency virus

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 immunerecovery 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. Immunerecovery 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. © 2012 Ophthalmic Communications Society, Inc.