Endogenous endophthalmitis caused by Histoplasma capsulatum var. capsulatum: a case report and literature review.
OBJECTIVE
We report the first case of clinically diagnosed endogenous endophthalmitis caused by Histoplasma capsulatum var. capsulatum in a patient with the acquired immune deficiency syndrome.


METHODS
Interventional case report and literature review.


METHODS
Pars plana vitrectomy and scleral buckling procedure in the left eye with intravenous and intravitreal amphotericin in both eyes.


METHODS
The clinical features, culture results, visual outcome, and complications were studied.


RESULTS
This case demonstrates a bilateral endophthalmitis with severe subretinal exudation, choroidal granulomas, and intraretinal hemorrhage leading to exudative bilateral retinal detachments. Vitreous cultures grew H. capsulatum var. capsulatum. Treatment consisted of intravenous amphotericin, intravitreal amphotericin (both eyes), pars plana vitrectomy (left eye), and scleral buckling procedure (left eye) with resulting counting fingers vision (right eye) and 20/300 (left eye). Four cases of Histoplasma endophthalmitis have been reported previously, all of which had a documented history of disseminated histoplasmosis and resulted in enucleation.


CONCLUSIONS
H. capsulatum should be considered a possible etiologic agent of endophthalmitis, especially in patients with a history of disseminated histoplasmosis and/or immune deficiency.
Gonzales
C A
CA
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33136, USA.
Scott
I U
IU
Chaudhry
N A
NA
Luu
K M
KM
Miller
D
D
Murray
T G
TG
Davis
J L
JL
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012164:Retinal Diseases / Q000209:etiology / Q000601:surgery; D012591:Scleral Buckling; D014821:Vitrectomy; D014822:Vitreous Body / Q000382:microbiology
D000935:Antifungal Agents; D000666:Amphotericin B