Severe Intraocular Sporotrichosis in Apparently Immunocompetent Patients: A Case Series
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Purpose
To report clinical findings and outcomes of three cases of intraocular sporotrichosis, and review the literature on this rare but severe manifestation of Sporothrix sp. infection.
Methods
Retrospective chart review of clinical data/laboratory results.
Results
Among three HIV-negative males, aged 36-44 years, two presented concomitant disseminated sporotrichosis associated with alcoholism and diabetes and close contact with cats, while the third was of a healthy individual with daily close contact with pigeons. One patient had bilateral disease; two patients with disseminated disease exhibited choroidal nodules with overlying nodular episcleritis, while the third case presented with anterior granulomatous uveitis, with iris nodules/hypopyon. Visual acuity (BCVA) at presentation ranged from 20/20–NLP (no light perception). Diagnosis was confirmed via biopsy/culture—two from skin lesions and one from ocular material. Treatment included intravenous amphotericin B, for disseminated and posterior segment disease, and PO voriconazole, for isolated anterior segment involvement, followed by prolonged maintenance therapy with PO itraconazole. Systemic/intraocular infection was controlled in all patients,. Final BCVA ranging from 20/20-20/60 in two patients, while the other maintained NLP, with follow-up ranging from 2- 24 months.
Conclusion
Intraocular inflammation is a very rare but severe complication of Sporothrix sp. infection, often associated with disseminated disease and clinical history of contact with cats (or more rarely pigeons). Early diagnosis is crucial for timely management. Antifungal therapy, adjusted to the severity of disease, followed by long-term maintenance antifungal may result in good outcomes.
Conflict of interest
No
1
Last name
MACHADO
Initials of first name(s)
D.O
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
2
Last name
Higino
Initials of first name(s)
ML
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
3
Last name
Freitas
Initials of first name(s)
H.M
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)
AC.H
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
5
Last name
Beneti
Initials of first name(s)
G.C
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
6
Last name
Vasconcelos-Santos
Initials of first name(s)
D.V
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
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