Sporothrix schenckii endophthalmitis in a patient with human immunodeficiency virus infection
A. Kurosawa, S. C. Pollock, M. P. Collins, C. R. Kraff and M. O. Tso
University of Illinois Hospital Eye and Ear Infirmary, Chicago.
A 30-year-old homosexual man with a positive serologic test for human
immunodeficiency virus and a history of successfully treated disseminated
cutaneous sporotrichosis developed a granulomatous uveitis that worsened
with topical and subconjunctival steroid therapy. Culture of the aqueous
aspirate yielded Sporothrix schenckii. The patient was treated with
intravenous amphotericin B and intravitreal amphotericin B, kanamycin
sulfate, and amikacin sulfate. Subsequent aqueous and vitreous cultures
were negative, but the intraocular inflammatory process progressed and
ultimately led to enucleation of the eye. Histopathologic examination
revealed granulomatous inflammation of the anterior uvea and scattered S
schenckii in the anterior and posterior chambers. Electron microscopy
demonstrated that most of the organisms had disorganized protoplasm.
Although treatment failed to ameliorate the progressive intraocular
inflammatory process, the negative cultures and the electron microscopic
observations suggest that the treatment was reasonably effective in killing
S schenckii within the eye. To our knowledge, this is the first case report
of S schenckii endophthalmitis in a patient with human immunodeficiency
virus infection.
