Solitary retinovitreal abscess as the initial manifestation of cryptococcosis

In a 63-year-old white man with a history of long-term use of systemic corticosteroids for polyarteritis nodosa, progressive clouding of vision in the right eye developed over a 2-month period. Cytologic analysis of a fine-needle aspiration biopsy of a solitary fluffy retinovitreal mass demonstrated Cryptococcus neoformans. Subsequent cerebrospinal fluid cultures were also positive for C. neoformans. Systemic antifungal therapy was given using amphotericin-B and 5-fluorocytosine. Proliferative vitreoretinopathy developed in the right eye within 8 months. Three small yellow retinal lesions, which later resolved, developed in the fellow eye.