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

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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.

This answer is incorrect. Patients with CMV retinitis typically do not present with conjunctival symptoms, nor do they typically have ocular pain or photophobia. Visual loss is a common initial presenting symptom and is often first detected as a visual field deficit.

A Cytomegalovirus (CMV) retinitis in HIV-infected patients usually results from reactivation disease in persons previously infected with CMV.
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.
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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