Retinal ischemic syndrome, digestive tract small-vessel hyalinosis, and diffuse cerebral calcifications: a pediatric observation of a rare syndrome.

thecosis include human immunodeficiencyvirus,leukemia,malignancies, hemodialysis, corticosteroid therapy, andcatheterization.Thepatientinthe currentstudywasreceivinglong-term immunosuppressivetherapyforgraftvs-hostdisease.Thesefactorslikelyled to the development of disseminated protothecosis. In summary, we present, to our knowledge, the first human case of choroiditis due to algae confirmed by pathological examination. This intraocular infection developed in the setting of positive cultures from 3 sites (skin, blood, and cerebrospinal fluid). Ocular involvement in the setting of disseminated protothecosis was confirmed by histopathological examination and PCR analysis. Although pathogenicprotothecosis is likely rare, our findings suggest that algae should be considered a pathogen in the differential diagnosis of choroiditis in the immunocompromised individual. Financial Disclosure: None. Correspondence: Dr Van Gelder, Department of Ophthalmology and Visual Sciences, CB 8096, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110 ([email protected] .edu).