Kohler James M, Mammo Danny A, Bennett Steven R, Davies John B
University of Utah Department of Ophthalmology & Visual Sciences, Salt Lake City, USA.
Cole Eye Institute, Cleveland Clinic, OH, USA.
Am J Ophthalmol Case Rep. 2022 Dec 10;29:101776. doi: 10.1016/j.ajoc.2022.101776. eCollection 2023 Mar.
To describe primary ocular toxoplasmosis infection related to ingestion of undercooked venison.
This single site, retrospective case series reviewed 4 patients with primary ocular toxoplasmosis that was acquired by ingesting undercooked venison. De-identified data was collected regarding baseline patient characteristics including age, sex, past medical and ocular history, onset of symptoms, visual acuity (VA), response to treatment, and workup. All patients with acquired toxoplasmosis had similar chronology of systemic and ocular symptoms. Exposure occurred in October or November and systemic symptoms developed within 2 weeks, followed by ocular symptoms an average of 2.6 months later. Average age at onset was 56 ± 13 (age ± SD) years old and all were male. Average initial and final VA were 20/50 and 20/50, respectively. Positive anti-toxoplasma IgM and IgG serologies were found in all cases. All patients were treated with trimethoprim/sulfamethoxazole and achieved rapid improvement. Complications occurred in 50% of cases and included epiretinal membrane, cystoid macular edema, vitreoretinal traction, and neovascularization.
Consumption of undercooked venison is a source of primary ocular toxoplasmosis even in immunocompetent hosts and has a clear chronology. A presentation of retinochoroiditis during the winter months should prompt questioning for exposure to wild game.
描述与食用未煮熟的鹿肉相关的原发性眼部弓形虫感染。
本单中心回顾性病例系列研究了4例因食用未煮熟的鹿肉而感染原发性眼部弓形虫病的患者。收集了去识别化的数据，内容包括患者基线特征，如年龄、性别、既往病史和眼部病史、症状发作情况、视力（VA）、治疗反应及检查结果。所有获得性弓形虫病患者的全身和眼部症状病程相似。暴露发生在10月或11月，全身症状在2周内出现，平均2.6个月后出现眼部症状。发病时的平均年龄为56±13（年龄±标准差）岁，均为男性。初始和最终平均视力分别为20/50和20/50。所有病例抗弓形虫IgM和IgG血清学检查均为阳性。所有患者均接受甲氧苄啶/磺胺甲恶唑治疗，病情迅速改善。50%的病例出现并发症，包括视网膜前膜、黄斑囊样水肿、玻璃体视网膜牵拉和新生血管形成。
即使在免疫功能正常的宿主中，食用未煮熟的鹿肉也是原发性眼部弓形虫病的一个来源，且有明确的病程。冬季出现视网膜脉络膜炎时，应询问是否接触过野生动物。
