Misdiagnosis of Ocular Adnexal Sporotrichosis: A Case Series

Sporotrichosis is a subacute or chronic infection affecting subcutaneous tissues, caused by the dimorphic fungus Sporothrix spp. This case series discusses three instances of ocular adnexal sporotrichosis treated at a tertiary government hospital in Pahang, Malaysia. It highlights diagnostic challenges, management strategies, and the impact of misdiagnosis and underreporting in the Southeast Asian tropical region compared to other parts of the world. Two of the three cases were initially misdiagnosed, leading to delays in definitive treatment. Incisional biopsies were performed for histopathological and fungal culture analysis, with two cases confirming the presence of Sporothrix spp. Following diagnosis, all patients responded well to oral fluconazole, although the recovery duration varied. Ocular sporotrichosis can be misdiagnosed due to its resemblance to other ocular conditions. Prompt diagnosis and early treatment are crucial to accelerating recovery and minimizing the risk of long-term ocular complications.