https://orcid.org/0000-0002-2703-0977
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ABSTRACT
Background
To report a case of coinfection of Toxoplasma gondii (Tg) and Epstein Barr Virus (EBV) in a diabetic patient with rheumatoid arthritis and immunosuppressive biological therapy.
Case presentation
A 70-year-old female with a history of rheumatoid arthritis on therapy with corticosteroids, methotrexate, and abatacept presented bilateral granulomatous panuveitis associated with retinal necrosis and macular involvement. A diagnostic vitrectomy detected Tg and EBV. Treatment with clindamycin, trimethoprim-sulfamethoxazole, and acyclovir was established, achieving improvement.
Conclusions
Patients undergoing immunosuppressive therapy are at risk of developing opportunistic infections, often presenting with severe and atypical clinical manifestations. In such cases, multiplex polymerase chain reaction is an invaluable diagnostic tool that helps identify the specific pathogens involved. This enables healthcare professionals to make informed treatment decisions and provide targeted therapy for each identified pathogen.
Acknowledgments
We thank the patient for granting permission to publish this information.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Authors’ contributions
GMS, CCP, CCG, and ADLT gathered and interpreted patient data. GMS and CCP were major contributors to writing the manuscript. CCG and ADLT revised the manuscript. ADLT provided clinical guidance and contributed to writing the manuscript. All authors read and approved the final manuscript.
Abbreviations
| OT | = | Ocular toxoplasmosis. |
| Tg | = | Toxoplasma gondii. |
| EBV | = | Epstein Barr Virus. |
| OD | = | Right eye. |
| OS | = | Left eye. |
| HSV 1–2 | = | Herpes simplex virus (1–2). |
| VZV | = | Varicella-zoster Virus. |
| TMP-SMX | = | Trimethoprim-sulfamethoxazole. |
Data availability statement
Patient information is not publicly available due to the protection of medical data privacy but is available on reasonable request from the corresponding author.
Consent for publication
Written informed consent was obtained prior to the publication of this case report. A copy of the informed consent can be requested for review to the Editor-in-Chief of this journal.