Case Study: July 2013


  • 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.


  1. What are the features of Figs 1,2 and 3?
  2. What does fig 4 show?
  3. What is the diagnosis?
  4. What is the differential for the precise species of agent seen in Fig 4?
  5. What else might be seen in the vitreous biopsy?
Click to show answers
  1. Vitreous acute abscess, with viable and effete neutrophils. Fig 2 shows some linear eosinophilic structures.
  2. Branching, septate fungi +++.
  3. Endogenous fungal acute endophthalmitis (the disease was bilateral).
  4. Aspergillus, Fusarium, Scedosporium apiospermum. In this case, culture and typing grew scedosporium apiospermum.
  5. Lymphoma, other infectious agents.