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Retinal involvement of Paracoccioidomycosis: A Case Report
Thais Z Igami1, Francisco Solano, Rony C Preti
1Department of Ophthalmology, University of São Paulo, School of Medicine (Hospital das Clínicas da Universidade de São Paulo- São Paulo- HC-USP)- Brazil ; Department of Ophthalmology, Santa Casa de São Paulo, Brazil.
Purpose:
to describe the clinicopathologic features and treatment of a rare case of systemic paracoccidioidomycosis with choroidal and retinal involvement.
Design:
retrospective interventional case report.
Participant:
A 36-year-old young man with visual impairment in left eye with anterior uveitis and presence of whitish perimacular choroidal nodule, multiple underlying whitish spots and mid-periphery exudative retinal detachment. A primary extensive work-up for systemic infectious, autoimmune, neoplasic or inflammatory conditions was performed and high-resolution computer tomography scan demonstrated asymmetric parietal thickening of the trachea and bilateral diffuse multiple lobular opacities. Pulmonary bronchoscopy/biopsy of larynx, trachea and bronchial tube were also performed. Histopathological evaluation showed characteristic of Paracoccidioidomycosis.
Intervention:
Patient was treated with oral sulphadiazine (1.5 g/day).
Main Outcome Measures:
Anterior uveitis, retinal examination, histopathological evaluation and primary clinical outcome were observed during systemic treatment.
Results:
After 3 months of irregular treatment, choroidal lesions decreased in size forming atrophic scars and fibrotic spots; however visual acuity did not show any improvement.
Conclusion:
We report a rare case of systemic paracoccidioidomycosis with choroidal and retinal involvement treated with oral sulphadiazine.
