Exophiala jeanselmei causing late endophthalmitis after cataract surgery

Am J Ophthalmol. 1999 Oct;128(4):512-4. doi: 10.1016/s0002-9394(99)00192-0.

Abstract

Purpose: To report two cases of late endophthalmitis caused by Exophiala jeanselmei after cataract surgery.

Methods: Case reports, including clinical evaluation, direct examination, and culture of the aqueous humor.

Results: In each case, samples from the anterior chamber had positive growth of yeasts with toruloid hyphae and pseudohyphae. Intravitreal and anterior chamber amphotericin B were used in both cases. Apparent clinical resolution was achieved, but after 3 months in one case and 6 months in the other the infection recurred more aggressively, with severe endophthalmitis leading to ocular atrophy.

Conclusion: E. jeanselmei causes a severe intraocular infection and isolation, and identification of the agent ensures proper diagnosis and treatment. After clinical resolution of the infection, careful and long-term follow-up is recommended to promptly detect relapse and immediately reintroduce treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / therapeutic use
  • Anterior Chamber / microbiology
  • Antifungal Agents / therapeutic use
  • Atrophy
  • Cataract Extraction*
  • Endophthalmitis / microbiology*
  • Endophthalmitis / pathology
  • Exophiala* / isolation & purification
  • Eye / pathology
  • Female
  • Humans
  • Middle Aged
  • Mycoses* / drug therapy
  • Postoperative Complications*
  • Recurrence

Substances

  • Antifungal Agents
  • Amphotericin B