ABSTRACT
A 33-year-old man presented with an ulcerated nodule on his left eyelid and eyebrow that was unresponsive to broad-spectrum antibiotics. Incisional biopsies were performed, and cultures were positive for Coccidioides immitis. An extensive work-up revealed no systemic involve ment of disseminated coccidioidomycosis. The patient was treated with oral itraconazole for 6 months with resolution of the lesion. Few cases of primary cutaneous coccidioidomycosis have been reported. The authors describe a primary cutaneous coccidioidomycosis lesion of the eyelid without disseminated disease.
Subject(s)
Coccidioides/isolation & purification , Coccidioidomycosis/microbiology , Dermatomycoses/microbiology , Eye Infections, Fungal/microbiology , Eyelid Diseases/microbiology , Administration, Oral , Adult , Antifungal Agents/therapeutic use , Coccidioidomycosis/diagnosis , Coccidioidomycosis/drug therapy , Dermatomycoses/diagnosis , Dermatomycoses/drug therapy , Eye Infections, Fungal/diagnosis , Eye Infections, Fungal/drug therapy , Eyelid Diseases/diagnosis , Eyelid Diseases/drug therapy , Humans , Itraconazole/therapeutic use , MaleABSTRACT
A 15-year-old boy presented with left-sided ptosis, upper eyelid swelling, proptosis, conjunctivitis, and a central corneal epithelial defect with thinning. MRI demonstrated an enhancing orbital mass associated with the lacrimal gland. Biopsy findings were consistent with orbital inflammatory syndrome. Topical cyclosporine and 1% methylprednisolone eliminated the anterior segment inflammation; subsequent treatment with systemic prednisone reduced the ptosis and edema. To our knowledge, this is the only reported case of orbital inflammatory syndrome associated with a corneal epithelial defect and thinning.
