Scedosporium apiospermum chorioretinitis

PURPOSE: A case of a 24-year-old immunocompetent woman who developed unilateral Scedosporium apiospermum chorioretinitis and diffuse cervical lymphadenitis 10 years after facial steroid injection is described. METHODS: The patient was initially treated for the misdiagnosis of tuberculous lymphadenitis. Contemporaneous to the enlargement of her lymph nodes, she experienced gradual loss of vision in her left eye. She subsequently underwent lymph node biopsy. RESULTS: Histopathologic sections stained with Grocott's methenamine silver showed branched septate hyphae and cultures on Sabouraud's agar yielded Scedosporium apiospermum. The patient received oral itraconazole 200 mg twice daily. Lymphadenitis regressed within a year and chorioretinitis scarred within two years. CONCLUSION: Scedosporium apiospermum may cause isolated chorioretinitis in an immunocompetent individual years after local surgery or trauma and result in significant visual morbidity. Treatment may require prolonged use of systemic itraconazole.