Latent disseminated blastomycosis with choroidal involvement

Abstract

A 36-year-old man developed blurred vision and a cough five months after traveling to an area from where a large outbreak of acute blastomycosis had been reported. Examination revealed a left choroidal lesion in the macular region, skin lesions on the right calf, and a left lung apical infiltrate. Histopathologic examination of the skin lesion demonstrated a granulomatous inflammation and broad based, budding yeast characteristic of Blastomyces dermatitidis. Amphotericin B therapy produced a rapid resolution of both choroidal and pulmonary lesions. During a six-month follow-up, there was no evidence of recurrence.