Isolated ocular cryptococcosis in an immunocompetent patient.
A 62-year-old woman without evidence of immunocompromise was evaluated for uveitis and a subretinal lesion in the right eye. Laboratory evaluation, including cerebrospinal fluid analysis, revealed no apparent cause. The diagnosis of subretinal cryptococcosis was established by transscleral needle biopsy of the subretinal mass. Treatment with intravenous amphotericin B and oral 5-flucytosine brought recovery of visual acuity to 20/30-1 and resolution of the inflammation. This patient demonstrates that ocular cryptococcal infection must be suspected, even in the absence of predisposing factors or systemic findings, and that subretinal fine-needle aspiration is an important diagnostic tool in this setting.
Hester
D E
DE
Department of Ophthalmology, University of North Carolina, Chapel Hill 27599-7040.
Kylstra
J A
JA
Eifrig
D E
DE
D000666:Amphotericin B / Q000627:therapeutic use; D003453:Cryptococcosis / Q000175:diagnosis* / Q000188:drug therapy; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D012164:Retinal Diseases / Q000188:drug therapy / Q000382:microbiology*; D014792:Visual Acuity
D000666:Amphotericin B; D005437:Flucytosine