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OCULAR SPOROTRICHOSIS: A FREQUENTLY MISDIAGNOSED CAUSE OF GRANULOMATOUS CONJUNCTIVITIS IN EPIDEMIC AREAS
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Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil.
Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil.
Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil.
Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil.
Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatologia Infecciosa. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Oftalmologia Infecciosa. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatologia Infecciosa. Rio de Janeiro, RJ, Brasil.
Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil.
Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil.
Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil.
Central Army Hospital. Department of Tropical Dermatology. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatologia Infecciosa. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Oftalmologia Infecciosa. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatologia Infecciosa. Rio de Janeiro, RJ, Brasil.
Abstract
Purpose: Sporotrichosis is a subcutaneous mycosis caused by Sporothrix sp., a dimorphic fungus. Although the cutaneous form is the most frequent form, the ocular presentation has been increasingly diagnosed in epidemic areas. We describe three cases of ocular sporotrichosis with the involvement of the ocular adnexa due to autoinoculation without trauma with successful antifungal treatment. Observations: Patient 1: A 68-year-old woman presented with granulomatous conjunctivitis of the right eye with an ulcerated nodule on the right temporal region for 5 months. Patient 2: A 46-year-old woman with conjunctival hyperemia of the left eye with associated periorbital edema and erythema for the past 4 months was referred to the Dermatology Department due to an ulcerated nodule on the left malar region. Patient 3: A 14-year-old boy presented to the emergency department with inferior palpebral edema with a 5-day evolution. Specimens were obtained from the lesions of the three patients, and the cultures were positive for Sporothrix sp. The three cases were diagnosed as ocular sporotrichosis and were successfully treated with itraconazole (200e400 mg/d). Two of the three patients developed sequelae such as conjunctival fibrosis and symblepharon. Conclusions and importance: We emphasize the importance of the ophthalmologist being familiar with the diagnosis and management of this rare and frequently misdiagnosed form of sporotrichosis.
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