Primary bilateral multifocal choroiditis as an initial manifestation of disseminated cryptococcosis in a HIV-positive patient.

PURPOSE: To report a rare case of primary bilateral multifocal choroiditis due to disseminated cryptococcus infection in a HIV-positive patient.

METHODS

Retrospective report. A 30-year-old asymptomatic HIV-positive male referred to us for a routine ophthalmic evaluation had bilateral, multiple choroidal lesions. CSF confirmed cryptococcus by India ink preparation and antigen by latex agglutination. The lesions began to resolve with intravenous amphotericin B and oral fluconazole.

CONCLUSIONS

Asymptomatic, primary, bilateral multifocal choroiditis due to cryptococcus is rare. A routine ophthalmic examination in HIV-positive patients can alert the treating physician to a possibility of a fatal disease.