Dual Retinitis with Cytomegalovirus and Herpes Simplex in a Paediatric Patient with Advanced Retinoblastoma: A Case Report

Authors

  • Inês Figueiredo Department of Ophthalmology, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal http://orcid.org/0000-0002-6037-2768
  • Joana Providência Department of Ophthalmology, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), Coimbra, Portugal; Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal https://orcid.org/0000-0003-1312-7978
  • Cristina Fonseca Department of Ophthalmology, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), Coimbra, Portugal; Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
  • Ana Madalena Monteiro Department of Ophthalmology, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), Coimbra, Portugal; Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal https://orcid.org/0009-0000-6469-5436
  • Guilherme Castela Department of Ophthalmology, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal; Clinical Academic Centre of Coimbra (CACC), Coimbra, Portugal; Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal https://orcid.org/0000-0003-0568-8265

DOI:

https://doi.org/10.48560/rspo.33251

Keywords:

Child, Cytomegalovirus Retinitis, Eye Infections, Viral, Herpes Simplex, Molecular Biology, Retinoblastoma

Abstract

Herpesvirus retinitis is a serious infection of the retina typically found in immunosuppressed patients. We report the case of a 4-year-old boy with a history of enucleation of the left eye for intraocular advanced retinoblastoma, at time under systemic adjuvant chemotherapy, observed under anaesthesia for periodic disease follow-up. Right eye fundus evaluation showed multiple areas of focal haemorrhagic retinitis without retinal necrosis along the mid and far periphery. Aqueous and peripheral blood polymerase chain reaction revealed dual positivity for cytomegalovirus and herpes simplex virus type 1. The patient was managed with three intravitreal foscarnet injections, intravenous ganciclovir and foscarnet and the lesions gradually regressed. However, two months later, a reactivation of retinitis lesions occurred and four additional intravitreal foscarnet injections were needed. In cases of suboptimal therapeutic response or atypical retinitis presentations, we believe that prompt molecular analysis of ocular fluids for viral DNA detection is crucial to correctly identify the causative agent.

 

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Published

2024-03-24

How to Cite

Figueiredo, I., Providência, J. ., Fonseca, C. ., Monteiro, A. M. ., & Castela, G. (2024). Dual Retinitis with Cytomegalovirus and Herpes Simplex in a Paediatric Patient with Advanced Retinoblastoma: A Case Report. Revista Sociedade Portuguesa De Oftalmologia, 48(1), 66–70. https://doi.org/10.48560/rspo.33251

Issue

Vol. 48 No. 1 (2024)

Section

Case Reports

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