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

You answered:

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.

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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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.
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.

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