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

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You answered:

	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.

This answer is incorrect. The diagnosis of CMV retinitis is based on characteristic funduscopic findings observed during a dilated funduscopic examination by an ophthalmologist. The diagnosis does not typically require lab-based or pathologic evidence of CMV.

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	Cytomegalovirus (CMV) retinitis in HIV-infected patients usually results from reactivation disease in persons previously infected with CMV.
	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.
	The patient in this case history had unusual presenting manifestations for CMV retinitis. Most patients present with eye pain, conjunctival erythema, and visual loss.

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