Reactivation of Ocular Toxoplasmosis in Immunosuppressed Neurosarcoidosis: A Case Report

Objective: To report a case of ocular toxoplasmosis reactivation in a patient with neurosarcoidosis undergoing immunosuppressive therapy. Methods: Case report and literature review. Results: A 34-year-old male with neurosarcoidosis, treated with Infliximab and Mycophenolate Mofetil, presented with sudden visual decline in his left eye. Multimodal imaging revealed active chorioretinitis. Serological tests showed elevated Toxoplasma IgG levels with normal IgM levels. Treatment with oral corticosteroids and antibiotics led to significant improvements in vitreous turbidity and lesion inactivity at follow-up, despite unchanged visual acuity. Conclusions: This case highlights the risk of toxoplasmosis reactivation in immunosuppressed sarcoidosis patients. It emphasizes the importance of considering ocular toxoplasmosis even with normal IgM levels, and demonstrates the value of multimodal imaging in diagnosis and follow-up.