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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