Ocular myositis as first presenting symptom of human immunodeficiency virus (HIV-1) infection and its response to high-dose cortisone treatment.

A 30-year-old male presented with signs of ocular inflammation and motility disturbances in an early stage of HIV infection. The provisional diagnosis of an ocular myositis was confirmed by orbital echograms. A general check up revealed positive anti-smooth-muscle antibodies and antinuclear antibodies as well as a raised erythrocyte sedimentation rate. Oral steroid treatment in addition to steroid eyedrops achieved complete resolution of clinical and sonographic symptoms within 15 weeks. Autoimmune phenomena are well known presentations of HIV infection. In this case oral cortisone proved to be an effective therapy even in the setting of an HIV infection.