Tinea corporis infection manifestating as retinochoroiditis-an unusual presentation

Tinea corporis, a superficial dermatophyte, is a fungal infection of the body. Ocular involvement due to dermatophytes can present as eyelid infestation. Various cases of retinochoroiditis have been reported secondary to infective etiology such as Toxoplasma gondii, Candida albicans, Trichosporon beigelii, and Sporotrichum schenkii. However, retinochoroiditis secondary to fungal infection of the skin caused by T. corporis has not been reported in the past.

A 45-year-old female presented with blurring of vision in the left eye for the last 20 days with a history of very severe itching on the abdomen and back. She had been diagnosed to have T. corporis infection by a dermatologist in the past, however, was non-compliant with the treatment. Anterior segment was within normal limits. Fundus examination of the right eye was normal and left eye showed a diffuse yellowish retinochoroiditis patch with irregular margins at the inferotemporal arcade. Optical coherence tomography (OCT) of the left eye through the macula showed shallow subretinal fluid with hyperreflective dots and passing through the retinochoroitidis patch showed increased retinal thickening with a pigment epithelial detachment and subretinal fluid. Left eye fundus fluorescein angiography (FFA) showed three hyperfluorescent areas along the inferotemporal arcade increasing in size and intensity with blurring of margins in the late phases. She had extensive reddish color erythematous plaque-like skin lesions over the abdomen and back. Treatment with oral itraconazole resulted in complete resolution of retinochoroiditis. Itraconazole is an orally active, triazole anti-fungal agent found to be effective in the management of dermatomycosis.

We report this case to highlight that one must rule out an infective etiology of retinochoroiditis before starting oral corticosteroids as it may worsen the infection especially fungal as in our patient. A detailed medical history and thorough examination helped us in diagnosing a systemic infective pathology and the possible cause of retinochoroiditis. To the best of our knowledge, this is the first case of infective retinochoroiditis secondary to T. corporis to be reported.