Treatment of two postoperative endophthalmitis cases due to Aspergillus flavus and Scopulariopsis spp. with local and systemic antifungal therapy

BMC Infect Dis. 2007 Jul 31:7:87. doi: 10.1186/1471-2334-7-87.

Abstract

Background: Endophthalmitis is the inflammatory response to invasion of the eye with bacteria or fungi. The incidence of endophthalmitis after cataract surgery varies between 0.072-0.13 percent. Treatment of endophthalmitis with fungal etiology is difficult.

Case presentation: Case 1: A 71-year old male diabetic patient developed postoperative endophthalmitis due to Aspergillus flavus. The patient was treated with topical amphotericin B ophthalmic solution, intravenous (IV) liposomal amphotericin-B and caspofungin following vitrectomy. Case 2: A 72-year old male cachectic patient developed postoperative endophthalmitis due to Scopulariopsis spp. The patient was treated with topical and IV voriconazole and caspofungin.

Conclusion: Aspergillus spp. are responsible of postoperative fungal endophthalmitis. Endophthalmitis caused by Scopulariopsis spp. is a very rare condition. The two cases were successfully treated with local and systemic antifungal therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use*
  • Ascomycota / drug effects*
  • Aspergillus flavus / drug effects*
  • Caspofungin
  • Drug Therapy, Combination
  • Echinocandins / therapeutic use
  • Endophthalmitis / drug therapy*
  • Endophthalmitis / microbiology
  • Humans
  • Lipopeptides
  • Male
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / microbiology
  • Pyrimidines / therapeutic use
  • Treatment Outcome
  • Triazoles / therapeutic use
  • Vitrectomy
  • Voriconazole

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Pyrimidines
  • Triazoles
  • Amphotericin B
  • Caspofungin
  • Voriconazole