Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole

Purpose. To report a case of postoperative endophthalmitis caused by Fusarium species successfully treated with intravitreal and systemic voriconazole after treatment failure with amphotericin B. Methods. Clinical case report of a 60-year-old immunocompetent woman who presents with endophthalmitis o...

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Main Authors: Paulo A. Alves da Costa Pertuiset, Juan F. Batlle Logroño
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2016/4593042
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author Paulo A. Alves da Costa Pertuiset
Juan F. Batlle Logroño
author_facet Paulo A. Alves da Costa Pertuiset
Juan F. Batlle Logroño
author_sort Paulo A. Alves da Costa Pertuiset
collection DOAJ
description Purpose. To report a case of postoperative endophthalmitis caused by Fusarium species successfully treated with intravitreal and systemic voriconazole after treatment failure with amphotericin B. Methods. Clinical case report of a 60-year-old immunocompetent woman who presents with endophthalmitis of unknown origin 4 weeks after uneventful cataract extraction and IOL implantation surgery. IOL explantation, vitrectomy with capsular bag removal, vitreous aspiration for culture, and intravitreal injection of amphotericin B (5 μg/0.1 mL) were performed. Diagnosis was established by culturing the vitreous aspirate on a Sabouraud agar medium and staining with lactophenol blue solution. Five days later, there was no clinical response. The decision was made to administer a single dose of intravitreal voriconazole (2.5 μg/0.1 mL) and oral voriconazole (200 mg BID) for 30 days. Results. Fusarium sp. grew on culture. Treatment with local and systemic voriconazole was started after no improvement with vitrectomy, IOL explantation, and intravitreal amphotericin B. After 1 month of treatment, the infection resolved and best-corrected visual acuity was 20/25. Conclusion. In patients with endophthalmitis caused by Fusarium sp., topical and systemic voriconazole treatment should be considered in cases resistant to intravitreal amphotericin B.
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spelling doaj-art-ec7e93edc2bb41cca37a1c80a0c5dc7d2025-08-20T02:21:49ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302016-01-01201610.1155/2016/45930424593042Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic VoriconazolePaulo A. Alves da Costa Pertuiset0Juan F. Batlle Logroño1Department of Ophthalmology, Clínica Santa María, Avenida Santa María 500, Providencia, 7520378 Santiago, ChileDepartment of Cornea and Refractive Surgery, Centro Laser, C/Fantino Falco 3, Naco, 10122 Santo Domingo, Dominican RepublicPurpose. To report a case of postoperative endophthalmitis caused by Fusarium species successfully treated with intravitreal and systemic voriconazole after treatment failure with amphotericin B. Methods. Clinical case report of a 60-year-old immunocompetent woman who presents with endophthalmitis of unknown origin 4 weeks after uneventful cataract extraction and IOL implantation surgery. IOL explantation, vitrectomy with capsular bag removal, vitreous aspiration for culture, and intravitreal injection of amphotericin B (5 μg/0.1 mL) were performed. Diagnosis was established by culturing the vitreous aspirate on a Sabouraud agar medium and staining with lactophenol blue solution. Five days later, there was no clinical response. The decision was made to administer a single dose of intravitreal voriconazole (2.5 μg/0.1 mL) and oral voriconazole (200 mg BID) for 30 days. Results. Fusarium sp. grew on culture. Treatment with local and systemic voriconazole was started after no improvement with vitrectomy, IOL explantation, and intravitreal amphotericin B. After 1 month of treatment, the infection resolved and best-corrected visual acuity was 20/25. Conclusion. In patients with endophthalmitis caused by Fusarium sp., topical and systemic voriconazole treatment should be considered in cases resistant to intravitreal amphotericin B.http://dx.doi.org/10.1155/2016/4593042
spellingShingle Paulo A. Alves da Costa Pertuiset
Juan F. Batlle Logroño
Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole
Case Reports in Ophthalmological Medicine
title Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole
title_full Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole
title_fullStr Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole
title_full_unstemmed Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole
title_short Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole
title_sort fusarium endophthalmitis following cataract surgery successful treatment with intravitreal and systemic voriconazole
url http://dx.doi.org/10.1155/2016/4593042
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