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Scedosporium apiospermum chorioretinitis
1Department of Ophthalmology, Section of Infectious Diseases, Hacettepe School of Medicine, Hacettepe University, Ankara, Turkey. hayyamk@ttnet.net.tr
Acta Ophthalmologica Scandinavica
|October 12, 2001
Summary
Scedosporium apiospermum can cause eye and lymph node infections years after facial steroid injections in immunocompetent individuals. Long-term itraconazole treatment may be required for resolution.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Facial steroid injections can rarely lead to opportunistic fungal infections.
- Scedosporium apiospermum is an emerging fungal pathogen.
- Ocular and systemic infections require prompt diagnosis and treatment.
Observation:
- A 24-year-old immunocompetent woman presented with unilateral chorioretinitis and cervical lymphadenitis 10 years post-facial steroid injection.
- Initial misdiagnosis as tuberculous lymphadenitis delayed appropriate antifungal therapy.
- Ocular symptoms of vision loss coincided with lymph node enlargement.
Findings:
- Histopathology revealed Scedosporium apiospermum with characteristic hyphae.
- Fungal cultures confirmed Scedosporium apiospermum.
- Treatment with oral itraconazole led to regression of lymphadenitis within a year and chorioretinitis scarring within two years.
Implications:
- Scedosporium apiospermum can cause severe, isolated chorioretinitis in immunocompetent hosts years after local procedures.
- Delayed diagnosis can lead to significant visual morbidity.
- Prolonged systemic antifungal therapy, such as itraconazole, is often necessary.
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