Bilateral fungal infection inducing a serpiginous-like picture
| Autor: | María Teresa Peláez, Beatriz Fernández-Vega Sanz, Jesus Merayo-Lloves, Alvaro Fernández-Vega González, Carlos Fernández-Vega González |
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| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine genetic structures Choroid Fundus Oculi business.industry Visual Acuity Retinitis General Medicine Middle Aged medicine.disease Fungal chorioretinitis Retina eye diseases Microbiology 03 medical and health sciences Ophthalmology 030104 developmental biology 0302 clinical medicine Mycoses 030221 ophthalmology & optometry medicine Humans sense organs business |
| Zdroj: | European Journal of Ophthalmology. 31:NP50-NP56 |
| ISSN: | 1724-6016 1120-6721 |
| Popis: | Purpose: To report the clinical findings of a patient who presented with an atypical bilateral fungal retinitis that was established by retinochoroidal biopsy. Methods: Case report. Results: A 56-year-old systemically healthy man presented with progressive visual loss in his left eye for 3 weeks. Visual acuity was 20/40 in the left eye, and 20/20 in the right eye and fundus examination showed macular retinal pigmented epithelium changes in his left eye. Over the following four months, his lesions progressed to serpiginous-like widespread retinal pigmented epithelium atrophy and his visual acuity decreased to 20/100, but no signs of ocular inflammation were found. Treatment with oral corticoids, valganciclovir and trimethoprim/sulfamethoxazole showed no efficacy. Blood analysis and cultures, laboratory investigations, and imaging tests were carried out looking for infectious and inflammatory diseases, but all tests were negative. Two months later, the patient presented with the same kind of lesions in the other eye (right eye), so he was subjected to retinochoroidal biopsy. Histopathological examination of specimen revealed the presence of intraretinal and choroidal fungal hyphae. Oral voriconazole was initiated achieving clinical remission, but no visual improvement was obtained. The source of the infection remains unknown since all tests results were negative. However, his profession as brewmaster might be related to the origin of the infection. Conclusion: Diagnosis of intraocular fungal infection can be challenging. Retinochoroidal biopsy may be useful to establish the diagnosis in those atypical cases with nonrevealing workup and inflammation localized to the retina. |
| Databáze: | OpenAIRE |
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