Reverse masquerade syndrome: Fungal adnexal infection mimicking carcinoma in a HIV-positive patient

Abstract

A known HIV-positive male patient presented with a rapidly progressive ulcerative lesion involving the conjunctiva, lids, and anterior orbit along with a decrease in vision in the right eye. He was on anti retro-viral and anti-tubercular therapy. In view of the clinical features, our provisional clinical diagnosis was a malignant lesion of the eyelid with orbital involvement, possibly squamous cell carcinoma. However, incisional biopsy revealed absence of malignant cells. On Gomori Methenamine Silver staining, plenty of fungal filaments were seen, which was confirmed by culture as Candida albicans. Hence, it turned out to be a case of fungal adnexal infection mimicking carcinoma in a HIV-positive patient. The patient responded well to systemic anti-fungals.

Keywords

• Chemotherapy
• focal treatment
• retinoblastoma
• Allergic eye disease
• papillae
• shield ulcer
• vernal keratoconjunctivitis
• Anti-VEGF injections
• bevacizumab
• neovascular age-related macular degeneration
• ranibizumab
• submacular hemorrhage
• Emergency department
• ocular
• trauma
• work related injuries
• Ocular trauma
• open globe injury
• preoperative (initial) visual acuity
• prognostic factors
• relative afferent pupillary defect
• Configuration
• choroidal neovascular membrane
• foveal slope
• foveal thickness
• neovascular age-related macular degeneration
• macular pigment
• Descemet membrane
• keratoplasty
• optical coherence tomography
• Central serous chorioretinopathy
• epidural steroid
• retinal pigment epithelium detachment
• retinal pigment epithelium tear
• Self-inflicted
• ocular injury
• needle
• Anterior chamber maintainer
• best corrected visual acuity
• neodymium yttrium aluminium garnet laser
• ocular visco-surgical device
• posterior capsule opacification
• AIDS
• Candida albicans
• reverse masquerade syndrome