A middle-aged man with choroidal granuloma
Abstract
A 32-year-old male presented with signs of focal choroiditis which evaluation found to be tubercular in origin. However, microbiological and histopathological examinations of vitreous and chorioretinal biopsy were suspicious of fungal infection. With a strong clinical suspicion of choroidal granuloma of presumed tubercular origin, the patient was commenced on antitubercular therapy (9 months) and oral steroids. The lesions started regressing with the disappearance of subretinal fluid 2 weeks following the start of antitubercular therapy. Visual acuity improved to 20/30 with chorioretinal scarring at the granuloma site after 6 months of therapy. In our case, despite the diagnosis of suspicious fungi (false-positive, possibly contaminant) on vitreous biopsy, clinical pointers (nature of the lesion, prevalence of disease, therapeutic response) helped us to diagnose choroidal granuloma. Prompt recognition and appropriate treatment helps to avoid the devastating consequences of the disease.
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