Successful treatment of bilateral endogenous Fusarium solani endophthalmitis in a patient with acute lymphocytic leukaemia

Mycoses. 2018 Jan;61(1):53-60. doi: 10.1111/myc.12697. Epub 2017 Sep 22.

Abstract

Fusarium spp. are an uncommon cause of fungaemia in immunocompromised and neutropenic patients that may hematogenously disseminate to the eyes. Herein, we describe a patient with acute lymphoblastic leukaemia and a prior history of extensive corticosteroid exposure who developed disseminated Fusarium solani infection following chemotherapy despite posaconazole prophylaxis. She was successfully treated with combination liposomal amphotericin B and voriconazole, intraocular injections of voriconazole, topical amphotericin B and bilateral vitrectomy. We also review published literature describing the management of endogenous Fusarium endophthalmitis in immunocompromised hosts.

Keywords: antifungal therapy; endophthalmitis; fungal infection; haematology; vitrectomy; voriconazole.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use*
  • Drug-Related Side Effects and Adverse Reactions
  • Endophthalmitis / drug therapy*
  • Endophthalmitis / microbiology
  • Female
  • Fungemia / drug therapy
  • Fungemia / microbiology
  • Fusariosis / blood
  • Fusariosis / drug therapy*
  • Fusariosis / microbiology
  • Fusarium / drug effects*
  • Fusarium / isolation & purification
  • Humans
  • Immunocompromised Host
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / microbiology
  • Pyrimidines / therapeutic use
  • Treatment Outcome
  • Triazoles / administration & dosage
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • liposomal amphotericin B
  • posaconazole
  • Amphotericin B
  • Voriconazole