Ocular Toxocariasis in an HIV-Positive Patient

Purpose: The aim of this study was to detail the first case of a patient with ocular toxocariasis, as an initial manifestation, who was eventually diagnosed with a positive human immunodeficiency virus (HIV) infection. Case summary: A 44-year-old man presented with a 1-month history of blurred vision and metamorphopsia in the right eye. He had no other relevant medical history. He denied having traveled out of the country or having any contact with animals or animal feces. He also denied consuming raw cow liver. At his initial visit, his best corrected visual acuity was 20/250 in the right eye, and 20/20 in the left eye. In the slit lamp examination, the conjunctiva of both eyes was clear and no inflammatory cells were observed. A dilated fundus examination and spectral domain optical coherence tomography revealed inflammatory exudates with fibrous tissue in the macula of the right eye. Toxocariasis antibody was serologically confirmed using enzyme-linked immunosorbent assay (ELISA), while HIV infection was confirmed by ELISA and western blotting. Conclusion: Because the ocular toxocariasis can be the first clinical manifestation in HIV-positive patients, the presence of ocular toxocariasis cannot exclude HIV infection and coinfection should be considered.