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Intraocular coccidioidomycosis diagnosed by skin biopsy
E T Cunningham1, S R Seiff, T G Berger
1The Francis I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, School of Medicine, 94143-0730, USA.
Objective:
To describe ocular findings in 2 patients with disseminated coccidioidomycosis diagnosed by skin biopsy.
Methods:
The clinical and histopathologic findings of the 2 patients were reviewed retrospectively.
Results:
One patient had a unilateral, granulomatous iridocyclitis with multiple iris nodules and a large vascularized anterior chamber mass, in the setting of pulmonary, cutaneous, and skeletal infection by Coccidioides immitis. The second patient developed papilledema and multifocal chorioretinitis accompanied by pulmonary, cutaneous, and meningeal C immitis infection. In each case, examination of the skin biopsy specimen revealed C immitis spherules. Treatments included local and systemic amphotericin B and oral fluconazole.
Conclusions:
Although rare, intraocular involvement can occur in the setting of disseminated coccidioidomycosis. A thorough systemic evaluation and biopsy of suspicious skin lesions can aid in the diagnosis.