Q. A 45-year-old woman is admitted to the hospital with complaints of fever, malaise, and night sweats for the past two weeks. She also reports a recent onset of blurry vision in both eyes. She has a history of HIV infection, with a CD4 count of 100 cells/mm3, and is non-adherent to her antiretroviral therapy.
On physical examination, she is found to have a low-grade fever and bilateral retinal lesions, with her fundoscopic examination revealing cotton wool spots and hemorrhages (see image). Her vision continues to deteriorate despite appropriate treatment. A repeat fundoscopic examination subsequently reveals an increase in the size and number of retinal lesions.
You consult a retina specialist for further management, and they recommend intravitreal injections of foscarnet. Which of the following is the most likely diagnosis?