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Case 7: A 43-Year-Old with New Visual Symptoms

You answered:

B In this situation, initiating antiretroviral therapy would be sufficient for treatment of the CMV retinitis. Specific therapy for CMV with valganciclovir (Valcyte) or a ganciclovir intraocular implant (Vitrasert) would not be necessary.

This answer is incorrect. Antiretroviral therapy alone is not appropriate therapy for CMV retinitis, especially in a patient who has already experienced loss of visual acuity. Most experts would recommend treatment with oral valganciclovir (Valcyte) with or without a ganciclovir intraocular implant (Vitrasert). The optimal time to initiate antiretroviral therapy in patients with acute CMV retinitis has not been clearly established.

Choose another answer:

A Cytomegalovirus (CMV) retinitis in HIV-infected patients usually results from reactivation disease in persons previously infected with CMV.
C The patient in this case history had unusual presenting manifestations for CMV retinitis. Most patients present with eye pain, conjunctival erythema, and visual loss.
D The diagnosis of CMV retinitis should be confirmed in all patients with suspected CMV retinitis by detecting CMV (using PCR-based techniques) in vitreous fluid.

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