UNIVERSITY OPHTHALMOLOGY CONSULTANTS
 

CASE OF THE MONTH

CASE #10

 
WHAT FURTHER TESTING WOULD YOU DO TO DETERMINE THE ETIOLOGY OF THE RETINAL GRANULOMA IN THIS PATIENT?

The patient underwent testing for sarcoidosis, tuberculosis, syphilis, bartonellosis, and toxocariasis. The tests performed included an ACE level, chest x-ray, PPD with control, RPR, FTA, CBC with differential, ESR, Bartonella titers, and serum ELISA for Toxocara antibody.

TEST   VALUE   REFERENCE RANGE
WBC 4.8 4.5 - 11.0 T/ul
EOS 4 0.3-5.0%
HGB 12.3 11.7-15.7 g/dL
HCT 37.3 34.9-46.9%
PLT 223 130-400 T/uL
SED 62 0-20 mm/h
FTA NON REACTIVE  
RPR NON REACTIVE  
ACE 43U/L  
CXR NEGATIVE  
PPD 11 mm induration (patient received BCG)  
Cat Scratch Dz (B. Henselae IgG, IgM) Negative  
Toxocara (ELISA) 1.82 <1.00 ( T. canis & T.cati)

 

PRESUMPTIVE DIAGNOSIS
       
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