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BRIEF COMMUNICATION
Year : 2017  |  Volume : 65  |  Issue : 6  |  Page : 526-528

Endogenous endophthalmitis caused by Cryptococcus neoformans Var. Gattii mimicking choroidal tumor: From positron-emission tomography/computed tomography to histopathology


1 School of Medicine, College of Medicine, China Medical University; Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC
2 School of Medicine, College of Medicine, China Medical University; Department of Ophthalmology, China Medical University Hospital, China Medical University; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan, ROC
3 Department of Ophthalmology, China Medical University Hospital, China Medical University; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, ROC

Correspondence Address:
Chun-Ju Lin
Department of Ophthalmology, 2 Yuh.Der Road, Taichung City, Taiwan 40447
ROC
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_543_16

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A 60-year-old immunocompetent female with pneumonia history about 10 years ago suffered from blurred vision overall survival for 3 weeks. Common cold with headache and unintentional body weight loss was also noted recently. Choroidal detachment simulating choroidal tumor was observed in the temporal quadrant. The 18F-fluoro-2-deoxyglucose (FDG) positron-emission tomography/computed tomography (CT) scan showed focal, mild to moderate FDG uptake in the left lateral orbit, and an enhanced lesion was seen on the recent CT scan. The suspicious choroidal tumor became larger in a week. Phacoemulsification, vitrectomy, and retinal biopsies were performed. Histochemical study of the retinal specimens established the diagnosis of endogenous cryptococcal endophthalmitis. Vitreous culture yielded Cryptococcus neoformans var. gattii. Systemic and topical voriconazole eliminated the infection. In the literature, endogenous endophthalmitis caused by C. neoformans var. gattii has not been reported in detail. The key to successful management lies in early diagnosis. If clinical improvement could not be achieved after conventional management and imaging studies have failed to yield a definite diagnosis, retinal biopsy can be considered.


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