A Case of Mistaken Identity - Ocular Histoplasmosis in Florida

Case Report

James McCluskey, Marie Bour

Abstract

Ocular Histoplasmosis Syndrome (OHS) is thought to develop when Histoplasmosis capsulatum spores settle in the choroid, obstruct choroidal vessels and stimulate neovascular growth. OHS is characterized by retinal scarring and Choroidal Neovascularization (CNV). Diagnosis of OHS is usually confirmed through the presence of ‘histo’ spots and retinal swelling. The former is considered presumptive of exposure to histoplasmosis spores and the latter results from the growth of abnormal blood vessels. Multifocal Choroiditis (MFC) mimics the presentation of OHS and diagnostic errors may occur. A thorough patient history, in conjunction with confirmatory laboratory testing for H. capsulatum exposure, can avoid misdiagnosis. We report a case of MFC misdiagnosed as OHS in a patient evaluated foroccupational exposure.

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