Fusarium Causing Recalcitrant Post-operative endophthalmitis-Report of a Case with Review of Literature

Ocul Immunol Inflamm. 2022 May 19;30(4):989-991. doi: 10.1080/09273948.2020.1830124. Epub 2021 Oct 12.

Abstract

Purpose: To study the clinical profile and management of a case of fungal postoperative endophthalmitis caused by fusarium solani.

Case report: A 40-year-old male underwent an uneventful cataract surgery developed postoperative endophthalmitis. The infection was fulminant and was treated aggressively with pars plana vitrectomy with intravitreal and oral antifungals. The microbiology culture of vitreous sample showed fusarium solani. There was a late recurrence in the form of a fungal ball behind the iris after 6 months of the initial episode. This fungal ball was then managed by transscleral cryotherapy. The eye became hypotonus due to chronic inflammation and silicone oil was instilled to salvage the eye.

Conclusion: Fusarium endophthalmitis needs an aggressive management. Due to late recurrence regular follow-up is mandatory. Early vitrectomy with oral and intravitreal voriconazole is the treatment of choice. Transscleral cryotherapy is a useful option to treat fungal balls behind the iris tissue.

Keywords: Fungal endophthalmitis; cryotherapy; fungal ball; fusarium; voriconazole.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Endophthalmitis* / diagnosis
  • Endophthalmitis* / drug therapy
  • Eye Infections, Fungal* / diagnosis
  • Eye Infections, Fungal* / drug therapy
  • Fusarium*
  • Humans
  • Male
  • Postoperative Complications / drug therapy
  • Vitrectomy / adverse effects
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Voriconazole

Supplementary concepts

  • Fusarium solani