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Retinal and choroidal infarction from Aspergillus: clinical diagnosis and clinicopathologic correlations.

ASPERGILLUS SPECIES EXISTS AS A SAPROPHYTIC FUNGUS COMMON IN SOIL and decaying organic matter. The species is widespread in our environment and its spores are readily disseminated via air currents. It can normally be isolated from the skin and mucous membranes including the conjunctiva. Aspergillus infections present in a variety ofways in susceptible humans. Inhalation of spores can cause bronchial asthma or allergic alveolitis. A frequent noninvasive or minimally invasive pulmonary colonization occurs following tissue damage from other diseases such as tuberculosis or bronchiectasis. A relatively indolent infection ofthe sinuses and orbits may be present. In the debilitated patient, however, Aspergillus invades and disseminates and may produce lesions in the lung, brain, kidney, gastrointestinal tract, myocardium, liver, spleen, and occasionally the eyes. Aspergillus endophthalmitisl-23 may be seen in patients with disseminated aspergillosis, following penetrating ocular trauma or surgery, or in intravenous drug abusers. This report presents three cases of endogenous aspergillosis with evidence of infarction of the retina. In all cases there was evidence of retinal vascular involvement clinically; choroidal whitening and exudative detachments suggested choroidal involvement in two cases (1 and 3). Histo-