Granulomatous Choroiditis in a Case of Disseminated Histoplasmosis

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Abstract
The identification of Histoplasma capsulatum in choroidal lesions of a fatal human case of disseminated histoplasmosis is described. Aside from granulomatous chorioretinitis, this patient had Addison's disease with bilateral adrenal calcification secondary to histoplasmosis of the adrenal glands and a cell-mediated immune deficiency. The fungus was isolated from bone marrow, skin, lymph nodes, and the cerebrospinal fluid during life and from the brain postmortem. The organisms observed within the choroid were identical to those in other tissues from which H capsulatum was isolated. The presence of H capsulatum in a granulomatous choroiditis fills a void in our knowledge about ocular histoplasmosis.