Bilateral retinal infarction in disseminated aspergillosis

A 10-month-old boy presented with malnutrition and fever of unknown origin. Treatment with steroids, antibiotics and total parenteral nutrition was unsuccessful, and progressive thrombotic complications led to death in 5 weeks. An antemortem diagnosis of embolic occlusion of both central retinal arteries was confirmed at autopsy. Aspergillus had invaded the blood vessels of many organs, including the eyes, and had proliferated within their lumina, causing thrombi and emboli to form and resulting in extensive tissue infarction, necrosis and hemorrhage.