Pseudallescheria endophthalmitis: four cases over 15 years in Queensland, Australia, and a review of the literature

Retina. 2014 Aug;34(8):1683-701. doi: 10.1097/IAE.0000000000000126.

Abstract

Purpose: To describe the clinical features and outcomes of patients with culture-proven Pseudallescheria endophthalmitis in the context of previously published cases.

Methods: A multicenter, retrospective, consecutive case series was undertaken. Pathology records were reviewed for all patients with Pseudallescheria endophthalmitis on vitreous/aqueous cultures from June 1998 to June 2013 throughout Queensland, Australia.

Results: Three females and 1 male aged 60 to 78 years were identified. All patients had endogenous endophthalmitis, had an underlying malignancy, and were from South East Queensland. Vitreous cultures identified Scedosporium auranticum in two cases and Scedosporium prolificans and Scedosporium apiospermum in one case each. All isolates were sensitive to voriconazole. Enucleation was required in two patients. Two patients had final best-corrected visual acuities of perception of light and no perception of light, respectively.

Conclusion: Endophthalmitis caused by species of the P. boydii complex is a devastating condition with poor visual outcomes. It is a condition that is difficult to treat because of its variable antifungal agent resistance.

Publication types

  • Case Reports
  • Multicenter Study
  • Review

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use
  • Combined Modality Therapy
  • Drug Therapy, Combination
  • Endophthalmitis / diagnosis
  • Endophthalmitis / microbiology*
  • Endophthalmitis / therapy
  • Eye Enucleation
  • Eye Infections, Fungal / diagnosis
  • Eye Infections, Fungal / microbiology*
  • Eye Infections, Fungal / therapy
  • Female
  • Humans
  • Intravitreal Injections
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mycoses / diagnosis
  • Mycoses / microbiology*
  • Mycoses / therapy
  • Queensland
  • Retrospective Studies
  • Scedosporium / isolation & purification*
  • Vitreous Body / microbiology

Substances

  • Antifungal Agents