FP231 : A Rare Case of Toxoplasma Choroiditis with Involvement of 2nd and 3rd Nerve of Left Eye

Dr. Deepak Choudhury, Dr.Jayashree Dora, Dr. Sharmistha Behera, Dr. Kanhei Charan Tudu, Dr. Jagdish Prasad Rout

A 30 yr HF presented with headache & blurring of vision of LE for 2 days. She had a history of contacts with cats in her house. Restricted adduction, elevation & depression of LE with mild ptosis. Pupil of LE- sluggishly reacting. Posterior segment- an isolated choroiditis patch along superior temporal arcade. ESR- 40, Toxoplasma IgG titre +ve (117), OCT showed hyperreflective patch along superior temporal arcade, MRI- mild diffusely thin left optic nerve with prominent perioptic CSF space. PCR of aqueous was +ve for toxoplasma. Oral Methylprednisolone 16mg TDS, tapered over 3 weeks, Vit-B12 1.5mg OD & Cotrimoxazole BD for 2weeks. On follow up after 1 week VA improved to 6/12. OCT- size of patch decreased after t/t. On follow up after 2 week, VA- 6/9, no ptosis, ocular movements- full & free in all direction. No identifiable patch on OCT. Conclusion:- It’s a rare case of toxoplasma choroiditis with 2nd & 3rd cranial nerve involvement. Complete recovery occurred after timely treatment.

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