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Case Study: July 2013
History
- 70 year old male with a history of haematological malignancy, presents with bilateral loss of vision.
- Examination showed bilateral viteous dense haze.
- Patient undergoes emergency vitreous biopsy.
- See figures 1,2,3 and 4.
Questions
- What are the features of Figs 1,2 and 3?
- What does fig 4 show?
- What is the diagnosis?
- What is the differential for the precise species of agent seen in Fig 4?
- What else might be seen in the vitreous biopsy?
Click to show answers
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- Vitreous acute abscess, with viable and effete neutrophils. Fig 2 shows some linear eosinophilic structures.
- Branching, septate fungi +++.
- Endogenous fungal acute endophthalmitis (the disease was bilateral).
- Aspergillus, Fusarium, Scedosporium apiospermum. In this case, culture and typing grew scedosporium apiospermum.
- Lymphoma, other infectious agents.
