UK patient with undiagnosed HIV suffers central vision loss

A middle aged man who presented at Royal Bolton Hospital with a sub foveal abscess was found to have septicaemia

Sub foveal abscess

A patient with an undiagnosed HIV infection and latent syphilis presented to emergency services with central vision loss.

Writing in BMJ Case Reports, clinicians highlighted that the middle aged man was suffering from a flu-like illness with fever when he arrived at Royal Bolton Hospital.

A “striking sub foveal abscess” was observed in the right fundus, while the left eye displayed acute chorioretinal inflammation.

He was diagnosed with staphylococcus aureus septicaemia. The patient also had an undiagnosed HIV infection and latent syphilis.

He was treated with intravenous flucloxacillin, resulting in a chorioretinal scar swiftly replacing the subfoveal abcess.

The patient was left with peripheral vision in his right eye and full vision in his left eye.

The authors noted that the patient was able to return to employment and satisfied legal requirements for driving.

Image credit: BMJ Case Reports 2018