CMV Retinitis with Thymoma: Is It Good Syndrome?

Drs. Nyaish Mansoor and Abdelsattar Farrag discuss the case of a 66-year-old woman with a history of thymoma who presents to the uveitis clinic with symptoms of pain, redness, and photophobia in the right eye. She was given a 7-week course of cyclopentolate and antiglaucoma medications for anterior uveitis, and the patient returned to the uveitis clinic 5 months after her initial visit with worsening symptoms. She was first treated empirically with an intravitreal injection of foscarnet 0.1 mL, given in the right eye to cover for viral retinitis, oral valaciclovir 1 gram 3 times daily, and oral azithromycin 500 mg once daily. A pan-PCR test yielded positive results for cytomegalovirus; when those results came in, the valacyclovir and azithromycin were stopped and the patient was started on valganciclovir at a loading dose of 900 mg twice daily. Good syndrome was ruled out due to inconclusive immunoglobulin test results.

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