Aspergillus iris granuloma: a case report with review of literature.
We report the case of a 25-year-old male patient who presented with complaints of redness, photophobia, and decreased vision in the right eye of a week's duration. Slit-lamp biomicroscopic examination revealed a cream-colored, irregular elevated inferior iris mass, extending on to the anterior lens surface. Differential diagnoses of a fungal granuloma, a medulloepithelioma, and an amelanotic melanoma were considered. An excisional biopsy of the mass was performed through a superior clear corneal incision. Polymerase chain reaction analysis of the aqueous humor showed a positive pan fungal genome. Histopathology of the biopsied mass showed a giant cell granuloma with surrounding numerous branching, septate hyphae. Culture growth revealed Aspergillus fumigatus We report this case because of the rarity of Aspergillus iris granuloma as a primary presentation of endogenous Aspergillosis and review the relevant literature. Absence of a significant systemic history compounded the diagnostic dilemma in our patient. Definitive differentiation of this rare entity from a foreign body, amelanotic melanoma, and other inflammatory conditions such as sarcoidosis and tuberculosis, may be possible only on microbiological and histo-pathological evaluation.
Jain
Vandana
V
Department of Cornea and Anterior Segment, Aditya Jyot Eye Hospital Pvt Ltd, Mumbai, India.
Dabir
Supriya
S
Shome
Debraj
D
Dadu
Tina
T
Natarajan
Sundaram
S
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000382:microbiology; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D001232:Aspergillus fumigatus / Q000235:genetics / Q000302:isolation & purification*; D001285:Atropine / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use; D004271:DNA, Fungal / Q000032:analysis; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D024841:Fluoroquinolones; D016681:Genome, Fungal / Q000235:genetics; D006101:Granuloma, Giant Cell / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007499:Iris Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D000077266:Moxifloxacin; D010866:Natamycin / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D011804:Quinolines / Q000627:therapeutic use
D000935:Antifungal Agents; D001372:Aza Compounds; D004271:DNA, Fungal; D024841:Fluoroquinolones; D011804:Quinolines; D001285:Atropine; D010866:Natamycin; D000077266:Moxifloxacin