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Histoplasmic endophthalmitis. A clinicopathologic correlation.

B G Goldstein, H Buettner

    Archives of Ophthalmology (Chicago, Ill. : 1960)
    |May 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

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    This case study details a patient with disseminated histoplasmosis (DH) and unusual ocular involvement, highlighting the diagnostic and therapeutic challenges of fungal endophthalmitis.

    Area of Science:

    • Ophthalmology
    • Infectious Diseases
    • Mycology

    Background:

    • Disseminated histoplasmosis (DH) can present with varied clinical manifestations.
    • Ocular involvement in DH typically manifests as the presumed ocular histoplasmosis syndrome (OHS).
    • This report describes a rare case of DH with atypical ocular presentation.

    Observation:

    • A patient with a 12-year history of relapsing DH presented with ocular symptoms.
    • Ocular findings included peripheral retinitis, vitreitis, and iritis, without characteristic OHS lesions.
    • Histoplasma capsulatum was identified in aqueous, vitreous, and iridectomy specimens.

    Findings:

    • The patient developed progressive necrotizing granulomatous iridocyclitis.
    • Despite treatment with amphotericin B, enucleation was necessary due to intractable pain.

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  • Histoplasma capsulatum was observed within ocular tissues, including the iris, ciliary body, and retina.

    • Implications:

    • This case underscores the importance of considering atypical ocular presentations in disseminated fungal infections.
    • Early diagnosis and aggressive management are crucial for sight preservation in fungal endophthalmitis.
    • Further research into the pathogenesis of ocular histoplasmosis is warranted.