| Presentation preference | Poster presentation |
| Title | Severe granulomatous anterior uveitis associated with paracoccioidomycosis: a diagnostic and therapeutic challenge |
| Accept poster if oral is not possible ? | Yes |
| Purpose | Report a rare case of severe granulomatous anterior uveitis associated with paracoccidioidomycosis |
| Methods | Retrospective chart review of clinical data/laboratory results |
| Results | A 5-year-old boy initially diagnosed with “conjunctivitis” in the left eye (OS) developed fever, cervical lymphadenopathy, facial and trunk skin lesions, and severe granulomatous anterior uveitis in OS. He was referred to our center with visual acuity (VA) of 20/20 in the right eye (OD) and 20/250 in OS. Intraocular pressure (IOP) was normal. Slit-lamp examination in OS showed granulomatous keratic precipitates, iris stromal and anterior chamber (AC) angle nodules, 4+ cells in the AC, while OD was unremarkable. Fundus examination was normal in both eyes (OU). Infectious screening and autoimmune markers were negative. Chest CT revealed hilar lymphadenopathy and diffuse micronodules. Skin biopsy disclosed large budding yeasts with a ship’s wheel pattern, consistent with Paracoccidioides sp. Treatment with intravenous amphotericin B and repeated AC lavage resulted in slow systemic and ocular infection control. Despite systemic and topical corticosteroids, the patient developed extensive peripheral anterior synechiae, secondary glaucoma, and bullous keratopathy, with best-corrected visual acuity (BCVA) limited to light perception, awaiting a penetrating keratoplasty. |
| Conclusion | Paracoccidioidomycosis is a rare systemic mycosis with unusual ocular involvement, typically presenting as conjunctival or eyelid lesions and, less commonly, choroiditis. This first report of anterior uveitis without posterior segment involvement highlights inclusion in the differential diagnosis of severe granulomatous anterior uveitis |
| Conflict of interest | No |
1
| Last name | BENETI |
| Initials of first name(s) | GC |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
2
| Last name | MARQUÉZ |
| Initials of first name(s) | LCR |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
3
| Last name | OLIVEIRA |
| Initials of first name(s) | IP |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
4
| Last name | ROCHA |
| Initials of first name(s) | ACH |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
5
| Last name | AZEVEDO |
| Initials of first name(s) | DOM |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
6
| Last name | DINIZ |
| Initials of first name(s) | LMO |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
7
| Last name | TEIXEIRA |
| Initials of first name(s) | DC |
| Department | Hospital das clínicas da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
8
| Last name | CAMPOS |
| Initials of first name(s) | WR |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
9
| Last name | VASCONCELOS-SANTOS |
| Initials of first name(s) | DV |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais ( UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
