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July 1996

Bilateral Endogenous Fusarium Endophthalmitis Associated With Acquired Immunodeficiency Syndrome

Author Affiliations

From The Jules Stein Eye Institute (Drs Glasgow, Engstrom, Holland, Kreiger, and Wool), the Ocular Inflammatory Disease Center (Dr Holland), and the Departments of Ophthalmology (Drs Glasgow, Engstrom, Holland, and Kreiger), Pathology (Drs Glasgow and Wool), and Medicine (Dr Wool), University of California-Los Angeles School of Medicine. Dr Engstrom is a David May II fellow in vitreoretinal diseases and surgery.

Arch Ophthalmol. 1996;114(7):873-877. doi:10.1001/archopht.1996.01100140087017

A 51-year-old man with acquired immunodeficiency syndrome and cytomegalovirus retinitis had bilateral endogenous fungal endophthalmitis. Cultures yielded Fusarium species. Histopathologic examination showed a severe necrotizing acute and granulomatous reaction, with numerous fungal elements in the retina and uveal tract. Fungal elements were seen in the lens, sclera, and emissarial vessels. Angiopathic infiltration by fungus and widespread thrombosis produced retinal and choroidal infarction. In some areas, fungal infection coexisted with cytomegalovirus retinitis. The bilateral distribution suggests hematogenous seeding of the eyes. The eye findings were the first clinically apparent manifestations of fungal disease in this patient.

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