Scleritis Due to Histoplasmosis.

Purpose: To describe the first-documented case of histoplasma scleritis in an immunocompetent patient.

Methods: Medical and pathological records of the patient described were reviewed.

Results: A 77-year-old immunocompetent man presented with necrotizing scleritis. Biopsy was consistent with histoplasma species, and culture results confirmed a causative agent of Histoplasma capsulatum. The patient required a long course of treatment, which included topical voriconazole and amphotericin, oral itraconazole and voriconazole, intravenous amphotericin, and periocular voriconazole and amphotericin. After 8 months of treatment, the patient's scleritis resolved, and he maintained good visual acuity.

Conclusions: To our knowledge, this is the second report of histoplasma scleritis in the literature and the first report in an immunocompetent patient.