Scedosporium apiospermum endophthalmitis: diffusion-weighted imaging in detecting subchoroidal abscess

Sandeep Bhuta, Charlie Chia-Tsong Hsu, Gigi Nga Chi Kwan

Griffith University, School of Medicine, Department of Medical Imaging, Gold Coast Hospital, Southport, Gold Coast, QLD, Australia

Purpose: To describe the imaging appearance of Scedosporium apiospermum (S. apiosermum) endophthalmitis in an immunocompetent female who underwent high resolution magnetic resonance imaging (MRI) of the orbits and showed subchoroidal abscess on diffusion-weighted imaging.
Methods: We highlight utility of MRI sequences: diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), fluid-attenuated inversion recovery (FLAIR), and contrast-enhanced magnetic resonance imaging (CE-MRI) in the detection of a subchoroidal abscess and characterization of the inflammatory change of the uveal tract. Vitreous culture grew S. apiospermum.
Conclusion: Fungal endophthalmitis is a rare but aggressive process. Clinically, it can mimic other disease entities such as neoplasm. To the best of our knowledge, this is the first case that describes the CT and MRI imaging findings of S. apiospermum endophthalmitis. We emphasize the use of DWI and ADC sequences in the detection of subchoroidal abscess.

Keywords: Secosporidium apiospermum, endophthalmitis, subchoroidal abscess, magnetic resonance imaging, diffusion-weighted imaging, contrast-enhanced magnetic resonance imaging