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Related Experiment Videos

Metastatic coccidioidal endophthalmitis.

J E Cutler, P S Binder, T O Paul

    Archives of Ophthalmology (Chicago, Ill. : 1960)
    |April 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

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    A severe eye inflammation initially misdiagnosed as tuberculosis uveitis improved with antifungal treatment for Coccidioides immitis. Despite treatment, the fungal infection led to eye removal, confirming disseminated coccidioidomycosis.

    Area of Science:

    • Ophthalmology
    • Mycology
    • Infectious Diseases

    Background:

    • Granulomatous iridocyclitis can present with pulmonary lesions, often initially suspected as tuberculosis.
    • Ocular infections require accurate etiological diagnosis for effective treatment.

    Observation:

    • A 29-year-old man presented with iridocyclitis and a cavitary pulmonary lesion, initially treated for pulmonary tuberculosis and tuberculous uveitis.
    • Despite improvement in the pulmonary lesion with antitubercular therapy, the patient's ocular condition worsened.

    Findings:

    • Anterior-chamber fluid analysis confirmed Coccidioides immitis as the causative agent.
    • Treatment with amphotericin B (intravenous and intracameral) was initiated.
    • The eye was enucleated three weeks post-treatment, remaining culture-positive for Coccidioides immitis, indicating treatment failure or extensive disease.

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    Implications:

    • This case highlights the importance of considering fungal infections, such as coccidioidomycosis, in the differential diagnosis of uveitis associated with pulmonary lesions.
    • Aggressive or disseminated fungal infections can lead to severe ocular morbidity despite treatment.
    • Histopathology confirmed diffuse anterior segment involvement by Coccidioides immitis spherules.