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array:23 [ "pii" => "S2387020622001243" "issn" => "23870206" "doi" => "10.1016/j.medcle.2021.11.006" "estado" => "S300" "fechaPublicacion" => "2022-04-08" "aid" => "5866" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Med Clin. 2022;158:350" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S002577532100676X" "issn" => "00257753" "doi" => "10.1016/j.medcli.2021.11.003" "estado" => "S300" "fechaPublicacion" => "2022-04-08" "aid" => "5866" "copyright" => "Elsevier España, S.L.U." 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=> "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775321006084?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622001206?idApp=UINPBA00004N" "url" => "/23870206/0000015800000007/v1_202205040609/S2387020622001206/v1_202205040609/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Cytomegalovirus retinitis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "350" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Magdalena Muelas-Fernandez, Helena Quintas-Marcos, Monica Ruiz-Pombo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Magdalena" "apellidos" => "Muelas-Fernandez" "email" => array:1 [ 0 => "magdamu80@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Helena" "apellidos" => "Quintas-Marcos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Monica" "apellidos" => "Ruiz-Pombo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Medicina Interna, Hospital de Viladecans, Institut Català de la Salut, Viladecans (Barcelona), Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Medicina Familiar y Comunitaria, Unidad Docente Costa Ponent-Área metropolitana Sud, Institut Català de la Salut, Castelldefels (Barcelona), Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Retinitis por citomegalovirus" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 714 "Ancho" => 755 "Tamanyo" => 45336 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 57-year-old male with no medical history of interest who came to the emergency department for blurred vision of one week's duration. Physical examination revealed fever of 38 °C, haemodynamic stability, oxygen saturation of 96%, eupnoea, cachexia and decreased bilateral visual acuity. He was referred to ophthalmology, where the fundus of the eye was analysed, reporting bilateral vitritis, multiple foci of retinitis with confluent areas of superimposed haemorrhages compatible with cytomegalovirus (CMV) retinitis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The patient reported a weight loss of 13 kg within the previous 2 months in the directed history-taking. Laboratory tests showed lymphopenia of 0.53 × 10<span class="elsevierStyleSup">9</span>/L, and rapid HIV serology was positive. The viral load was 2,696,865 copies/mL and the CD4 count was 45 (7%). The serologies for CMV were positive for IgG and IgM and the viral load was 68,771 IU/mL. Chest X-ray showed a ground-glass pattern, so fiberoptic bronchoscopy was requested and specimens were positive for <span class="elsevierStyleItalic">Pneumocystis jirovecii</span>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Treatment was started with intravenous trimethoprim/sulfamethoxazole (15 mg/kg daily), intravenous and intravitreal ganciclovir (5 mg/kg daily), and retroviral treatment with tenofovir alafenamide (25 mg daily), emtricitabine (200 mg daily) and bictegravir 50 mg (daily).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Prior to 1995, CMV retinitis occurred in approximately 1 in 3 people diagnosed with HIV infection in Western countries and accounted for more than 90% of cases of HIV-associated blindness.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-08-11" "fechaAceptado" => "2021-11-09" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Muelas-Fernandez M, Quintas-Marcos H, Ruiz-Pombo M. Retinitis por citomegalovirus. 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