Bilateral granulomatous uveitis mimicking tuberculosis: an atypical ocular presentation of biopsy-proven disseminated histoplasmosis.
Shikha Agarwal, Prolima Thacker, Sunita Yadav et al.
✦ AI-curated · Sources linked
Case in brief
A middle-aged immunocompetent male farmer presented with acute bilateral visual loss, redness, and floaters. Examination revealed bilateral granulomatous anterior uveitis with dense vitritis and significant anterior chamber reaction. Systemic evaluation identified a laryngeal mass, and histopathology confirmed disseminated Histoplasma capsulatum infection. Treatment with itraconazole and corticosteroids led to marked clinical improvement and visual recovery within one week.
What made this case unusual
This case highlights an atypical inflammatory presentation of ocular histoplasmosis, which closely mimicked tuberculosis, complicating the diagnostic process.
Diagnostic / clinical pearl
Clinicians should consider disseminated histoplasmosis in cases of bilateral granulomatous uveitis, especially in endemic regions, and prioritize systemic evaluation and tissue diagnosis.
Why it matters
This case emphasizes the need for careful differentiation between infectious causes of uveitis to avoid misdiagnosis and ensure appropriate treatment.