Inflammatory pseudohistoplasmosis.

In patients with multifocal choroiditis, presumed ocular histoplasmosis syndrome (POHS) is often diagnosed. However, POHS typically is not associated with inflammatory activity in the ocular media. A group of patients had a pattern of multifocal choroidal spots reminiscent of POHS with active signs of inflammation in the anterior and vitreous chambers. Of the 28 patients, 43% were black. In addition to inflammation, many patients had peripapillary atrophy (39%) or diskiform macular scars (32%). Of those with diskiform scars, 33% were black. Systemically, 32% of the patients were presumed to have sarcoidosis; 29%, tuberculosis; 11%, syphilis; and 28%, no etiology. In some cases, treatment of the underlying disease resulted in improvement of the ocular findings. Inflammatory pseudohistoplasmosis syndrome appears to be a nonspecific response to a number of uveitic syndromes, including sarcoidosis, tuberculosis, and syphilis.