ACUTE VISUAL-LOSS BECAUSE OF MYCOTIC INFE CTION IN CHRONIC MYELOGENEOUS LEUKEMIA

Patient A 35-year-old man had suffered from leukemia since September 1 990. A transplantation of bone marrow was carried out in February 1994 . He developed a graft versus-host disease in November 1995. In Decemb er 1995 a keratoplasty was necessary because of a perforated corneal u lcer. 17 days later the patient noted a complete loss of vision, first in the left and one day later in the right eye. The optic nerve head was white and the retina looked ischaemic like in central retinal arte ry occlusion. A hypodensic area was found in the frontal brain reachin g up to the optic chiasm in computer tomography. Inspite of intensive treatment the immunosuppressed patient died 4 days after he had became blind. Autopsy showed a mycotic infiltration by mucormycosis of the b rain and the right optic nerve sheath. This human-pathogenic fungal in fection belongs to the group of mould as well as aspergillus. Conclusi on Mycosis should be considered in the differential diagnosis of acute visual loss in immunosuppressed patients.