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Disseminated Cryptococcus with ocular cryptococcoma in a human immunodeficiency virus-negative patient.

Zvi A Kresch¹, Diego Espinosa-Heidmann, Tiffany Harper

¹Department of Ophthalmology, School of Medicine, West Virginia University, Morgantown, WV, USA. kreschz@wvuhealthcare.com

International Ophthalmology

|March 24, 2012

Summary

A man with autoimmune hemolytic anemia developed vision and hearing loss. Disseminated Cryptococcus infection, initially mistaken for sarcoidosis, was successfully treated with antifungal therapy.

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Area of Science:

Ophthalmology
Infectious Diseases
Immunology

Background:

Autoimmune hemolytic anemia (AIHA) is a condition where the immune system attacks red blood cells.
Human immunodeficiency virus (HIV)-negative individuals can also experience opportunistic infections.
Ocular and neurological manifestations can occur in disseminated fungal infections.

Observation:

A 63-year-old male with AIHA presented with decreased vision, photophobia, and hearing loss.
Initial diagnostic workup suggested sarcoidosis.
Further investigations revealed disseminated Cryptococcus infection with a left eye cryptococcoma.

Findings:

Disseminated Cryptococcus infection can mimic other granulomatous diseases like sarcoidosis.
Ocular cryptococcoma is a rare but serious manifestation of disseminated cryptococcosis.
Systemic antifungal therapy is effective in treating cryptococcal infections.

Implications:

Early and accurate diagnosis of disseminated fungal infections is crucial, even in HIV-negative patients.
Ophthalmologists and infectious disease specialists should consider fungal infections in patients with unexplained visual disturbances and systemic symptoms.
Prompt treatment with systemic antifungals can lead to favorable outcomes in disseminated cryptococcosis.