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BRIEF COMMUNICATION
Year : 2013  |  Volume : 61  |  Issue : 12  |  Page : 763-765

A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology


1 Department of Ophthalmology, A-Floor, Royal Hallamshire Hospital, Sheffield S10 2JF, Sheffield, United Kingdom
2 Department of Infectious Diseases, E-Floor, Royal Hallamshire Hospital, Sheffield S10 2JF, Sheffield, United Kingdom
3 University Department of Ophthalmology and Orthoptics, Sheffield University, K-Floor, Royal Hallamshire Hospital, Sheffield S10 2JF, Sheffield, United Kingdom
4 National Specialist Ophthalmic Pathology Laboratory (NSOPS), Histopathology Department, E-Floor, Royal Hallamshire Hospital, Sheffield S10 2JF, Sheffield, United Kingdom

Correspondence Address:
Hardeep Singh Mudhar
National Specialist Ophthalmic Pathology Laboratory (NSOPS), Histopathology Department, E-Floor, Royal Hallamshire Hospital, Sheffield S10 2JF, Sheffield
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.124773

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A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.


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