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Presumed multifocal cryptococcol choroidopathy prior to specific systemic manifestation
K Rostomian1, P U Dugel, A Kolahdouz-Isfahani
1Department of Ophthalmology, Doheny Eye Institute, University of Southern California School of Medicine, Los Angeles, USA.
International Ophthalmology
|January 1, 1997
Summary
Ocular lesions can be the first sign of disseminated cryptococcosis in individuals with acquired immunodeficiency syndrome (AIDS). Early detection through funduscopic examination enables prompt treatment, improving outcomes for this serious fungal infection.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Disseminated cryptococcosis is a significant cause of illness and death in immunocompromised individuals, particularly those with acquired immunodeficiency syndrome (AIDS).
- Prompt diagnosis and treatment are crucial for improving patient outcomes in disseminated cryptococcosis.
Observation:
- Three patients with AIDS presented with multifocal choroiditis and choroidal lesions as the initial clinical manifestation of disseminated cryptococcosis.
- These patients were treated with systemic amphotericin B and flucytosine, with accompanying cerebrospinal fluid (CSF) evaluation.
Findings:
- All three patients with initial choroidal lesions showed positive cryptococcus titers or cultures in their CSF.
- Choroidal lesions resolved within one to three months following systemic antifungal therapy, suggesting cryptococcal etiology.
Implications:
- Primary choroidal lesions in AIDS patients can indicate severe systemic disseminated disease.
- Funduscopic examination is vital for detecting disseminated cryptococcal disease early, preceding other symptoms and allowing timely intervention.