Mycobacterium chimaera choroidal granuloma: A case report and review of the literature

Purpose

To report a case of a patient that developed a choroidal granulomatous lesion secondary to disseminated Mycobacterium chimaera (MC) infection that was successfully treated with systemic and ocular steroids.

Observations

A 60-year-old male with a history of multiple cardiothoracic surgeries complicated by disseminated MC was referred to retina clinic. On initial examination, bilateral choroidal lesions were noted consistent with MC choroiditis. These lesions were treated with systemic antimicrobials. Five months later, the patient was found to have a new choroidal lesion in his right eye concerning for a choroidal granuloma. Optical coherence tomography showed an elevated choroidal lesion with subretinal fluid. The granulomatous choroidal lesion regressed after starting systemic and local steroids. There was no recurrence of the granulomatous choroidal lesion at the most recent follow up visit.

Conclusions and Importance

This is an extremely rare report of a patient who received successful treatment for a MC related choroidal granulomatous lesion with accompanying multimodal imaging. The report suggests that similar lesions can be treated with systemic and ocular steroid therapy in combination with systemic antimicrobials.