BILATERAL ENDOGENOUS FUSARIUM-ENDOPHTHALMITIS ASSOCIATED WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME

A 51-year-old man with acquired immunodeficiency syndrome and cytomega lovirus retinitis had bilateral endogenous fungal endophthalmitis. Cul tures yielded Fusarium species. Histopathologic examination showed a s evere necrotizing acute and granulomatous reaction, with numerous fung al elements in the retina and uveal tract. Fungal elements were seen i n the lens, sclera, and emissarial vessels. Angiopathic infiltration b y fungus and widespread thrombosis produced retinal and choroidal infa rction. In some areas, fungal infection coexisted with cytomegalovirus retinitis. The bilateral distribution suggests hematogenous seeding o f the eyes. The eye findings were the first clinically apparent manife stations of fungal disease in this patient.