Severe granulomatous anterior uveitis associated with paracoccioidomycosis: a diagnostic and therapeutic challenge
Accept poster if oral is not possible ?
Yes
Purpose
Report a rare case of severe granulomatous anterior uveitis associated with paracoccidioidomycosis
Methods
Retrospective chart review of clinical data/laboratory results
Results
A 5-year-old boy initially diagnosed with “conjunctivitis” in the left eye (OS) developed fever, cervical lymphadenopathy, facial and trunk skin lesions, and severe granulomatous anterior uveitis in OS. He was referred to our center with visual acuity (VA) of 20/20 in the right eye (OD) and 20/250 in OS. Intraocular pressure (IOP) was normal. Slit-lamp examination in OS showed granulomatous keratic precipitates, iris stromal and anterior chamber (AC) angle nodules, 4+ cells in the AC, while OD was unremarkable. Fundus examination was normal in both eyes (OU). Infectious screening and autoimmune markers were negative. Chest CT revealed hilar lymphadenopathy and diffuse micronodules. Skin biopsy disclosed large budding yeasts with a ship’s wheel pattern, consistent with Paracoccidioides sp. Treatment with intravenous amphotericin B and repeated AC lavage resulted in slow systemic and ocular infection control. Despite systemic and topical corticosteroids, the patient developed extensive peripheral anterior synechiae, secondary glaucoma, and bullous keratopathy, with best-corrected visual acuity (BCVA) limited to light perception, awaiting a penetrating keratoplasty.
Conclusion
Paracoccidioidomycosis is a rare systemic mycosis with unusual ocular involvement, typically presenting as conjunctival or eyelid lesions and, less commonly, choroiditis. This first report of anterior uveitis without posterior segment involvement highlights inclusion in the differential diagnosis of severe granulomatous anterior uveitis
Conflict of interest
No
1
Last name
BENETI
Initials of first name(s)
GC
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
2
Last name
MARQUÉZ
Initials of first name(s)
LCR
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
3
Last name
OLIVEIRA
Initials of first name(s)
IP
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
4
Last name
ROCHA
Initials of first name(s)
ACH
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
5
Last name
AZEVEDO
Initials of first name(s)
DOM
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
6
Last name
DINIZ
Initials of first name(s)
LMO
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
7
Last name
TEIXEIRA
Initials of first name(s)
DC
Department
Hospital das clínicas da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
8
Last name
CAMPOS
Initials of first name(s)
WR
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
9
Last name
VASCONCELOS-SANTOS
Initials of first name(s)
DV
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG)
City
Belo Horizonte
Country
Brazil
This website uses cookies to ensure you get the best experience on our website.
Learn more