PMC4378873_01
Fundus photo of the right eye showed a slightly pale optic disc, a generalized pale retina, and the presence of a cherry red spot at the posterior pole.
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Fundoscopy revealed a slightly pale optic disc, a generalized pale retina, and the presence of a cherry red spot at the posterior pole, suggestive of CRAO of the right eye (Figure 1).
Fundus photo of the left eye.. Notes: (A) Initial single choroiditis on presentation. (B) Progression to endophthalmitis with multifocal chorioretinitis and overlying minimal vitritis at 3 weeks of systemic D-AMB. (C) Complete resolution of chorioretinitis and vitritis after intravitreal AMB and completed systemic L-AMB.. Abbreviations: D-AMB, amphotericin B deoxycholate; AMB, amphotericin B; L-AMB, liposomal amphotericin B.
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Fundoscopy of the left eye showed a white creamy subretinal nodule at the inferior arcade close to the optic disc, suggesting choroiditis; however, no vitritis was observed (Figure 2A). At 3 weeks of treatment, the choroiditis in the left eye progressed to endogenous fungal endophthalmitis with multifocal chorioretinitis and overlying minimal vitritis (Figure 2B). There was complete resolution of chorioretinitis and vitritis in the left eye (Figure 2C), with a final best-corrected visual acuity of 6/9.
Contrast-enhanced computed tomography of the brain, orbit, and paranasal sinuses.. Notes: This image showed mucosal thickening of the right ethmoidal sinus (yellow arrow) and fluid in the right sphenoidal sinus (red arrow), compatible with sinusitis.
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Computed tomography scan of the brain, orbit, and paranasal sinuses showed mucosal thickening and fluid in the right ethmoidal and sphenoidal sinuses compatible with sinusitis (Figure 3).
Black eschar seen in the right nasal sinus through sinus endoscopy.
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Nasal and sinus endoscopy by the otorhinolaryngology team showed black eschar in the right sinuses (Figure 4).