Exophiala dermatitidis Endophthalmitis: Case Report and Literature Review

Mycopathologia. 2018 Jun;183(3):603-609. doi: 10.1007/s11046-017-0235-4. Epub 2018 Jan 27.

Abstract

We report a case of a 59-year-old male patient with a postoperative fungal infection of the left eye. A dark-pigmented yeast, Exophiala dermatitidis (previously known as Wangiella dermatitidis), was identified from the culture of the biopsy taken from the posterior capsule. The infection was successfully eradicated by a combination of surgical and medical (i.e., voriconazole and fluconazole) treatment. This is the first report of successfully treated E. dermatitidis endophthalmitis, which demonstrates that a prompt and aggressive antifungal therapy combined with surgical intervention is necessary to prevent vision loss in cases of endophthalmitis due to Exophiala species. Beside the case description, we also aim to provide a literature review of previously reported eye infections caused by Exophiala species in order to help the future diagnosis and management of the disease.

Keywords: Antifungal susceptibility; Dematiaceous fungi; Endophthalmitis; Exophiala; Keratitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antifungal Agents / administration & dosage
  • Biopsy
  • Debridement
  • Endophthalmitis / diagnosis*
  • Endophthalmitis / microbiology
  • Endophthalmitis / pathology*
  • Endophthalmitis / therapy
  • Exophiala / isolation & purification*
  • Humans
  • Male
  • Microbiological Techniques
  • Middle Aged
  • Phaeohyphomycosis / diagnosis*
  • Phaeohyphomycosis / microbiology
  • Phaeohyphomycosis / pathology*
  • Phaeohyphomycosis / therapy
  • Pigments, Biological / analysis
  • Surgical Wound Infection / diagnosis*
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / pathology*
  • Surgical Wound Infection / therapy
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Pigments, Biological