{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T12:14:16Z","timestamp":1788178456021,"version":"build-2803163510"},"reference-count":8,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,16]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Ocular histoplasmosis typically presents as presumed ocular histoplasmosis syndrome, characterised by chorioretinal scars and peripapillary atrophy without intraocular inflammation. Active inflammatory presentations are exceedingly rare and may closely mimic tuberculosis in endemic regions, posing significant diagnostic challenges.<\/jats:p>\n                  <jats:p>\n                    We report a middle-aged immunocompetent male farmer who presented with acute bilateral visual loss, redness and floaters. Examination revealed bilateral granulomatous anterior uveitis with dense vitritis with mutton-fat keratic precipitates, dense vitritis and 4+ anterior chamber reaction. Systemic evaluation identified a laryngeal mass; histopathological examination confirmed disseminated\n                    <jats:italic>Histoplasma capsulatum<\/jats:italic>\n                    infection. QuantiFERON-TB Gold and HIV serology were negative. Itraconazole was initiated before systemic corticosteroids, with marked clinical improvement and visual recovery from 6\/60 to 6\/18 bilaterally within 1\u2009week.\n                  <\/jats:p>\n                  <jats:p>This case underscores the importance of systemic evaluation, tissue diagnosis and appropriate antifungal cover preceding corticosteroid use in presumed histoplasma-associated granulomatous uveitis in endemic settings.<\/jats:p>","DOI":"10.1136\/bcr-2026-275096","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:20:15Z","timestamp":1788175215000},"page":"e275096","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral granulomatous uveitis mimicking tuberculosis: an atypical ocular presentation of biopsy-proven disseminated histoplasmosis"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4675-5690","authenticated-orcid":false,"given":"Shikha","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prolima","family":"Thacker","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunita","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nistha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luxmi","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2026083104200851000_19.8.e275096.1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(60)91515-4"},{"key":"2026083104200851000_19.8.e275096.2","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/ICU.0000000000000100","article-title":"Presumed ocular histoplasmosis","volume":"25","author":"Thuruthumaly","year":"2014","journal-title":"Curr Opin Ophthalmol"},{"key":"2026083104200851000_19.8.e275096.3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.survophthal.2015.02.005","article-title":"Ocular histoplasmosis syndrome","volume":"60","author":"Diaz","year":"2015","journal-title":"Surv Ophthalmol"},{"key":"2026083104200851000_19.8.e275096.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.iio.0000155934.52589.e3"},{"key":"2026083104200851000_19.8.e275096.5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1080\/09273940701375428","article-title":"Presumed ocular histoplasmosis syndrome in India","volume":"15","author":"Sinha","year":"2007","journal-title":"Ocul Immunol Inflamm"},{"key":"2026083104200851000_19.8.e275096.6","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1080\/09273948.2020.1797114","article-title":"Diagnostic and Therapeutic Challenges in Ocular Histoplasmosis - A Case Report","volume":"30","author":"Kawali","year":"2022","journal-title":"Ocul Immunol Inflamm"},{"key":"2026083104200851000_19.8.e275096.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-025-11862-x","article-title":"Histoplasmosis in India: clinical insights from a tertiary care hospital","volume":"25","author":"Soni","year":"2025","journal-title":"BMC Infect Dis"},{"key":"2026083104200851000_19.8.e275096.8","doi-asserted-by":"publisher","DOI":"10.1086\/521259"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-275096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:20:16Z","timestamp":1788175216000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-275096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":8,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,31]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bcr-2026-275096"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-275096","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}