Excellent visual outcome following Aspergillus flavus endogenous endophthalmitis-farmer's lung disease

Int Ophthalmol. 2010 Feb;30(1):99-101. doi: 10.1007/s10792-008-9289-0. Epub 2009 Jan 9.

Abstract

Introduction: The purpose is to report an eye with endogenous Aspergillus flavus endophthalmitis that achieved a good visual outcome following early and aggressive management.

Methods: A 76-year-old male recently hospitalized for allergic Aspergillus pneumonitis after cleaning out a grain bin presented with reduced vision and anterior chamber and vitreous inflammation. The patient was treated with intravenous amphotericin and a pars plana vitrectomy with intravitreal amphotericin, and the vitreous biopsy sent for histopathological and microbial analysis.

Results: A. flavus was isolated from the vitreous biopsy. Two weeks after vitrectomy, intravitreal amphotericin was again injected into the affected eye. The patient regained vision to 20/80 several months later, despite a moderate cataract.

Conclusion: Early treatment of A. flavus endophthalmitis with pars plana vitrectomy, intravitreal and systemic amphotericin can lead to good visual outcomes.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / administration & dosage
  • Anterior Chamber / microbiology
  • Anterior Chamber / pathology
  • Antifungal Agents / administration & dosage
  • Aspergillosis / complications*
  • Aspergillosis / microbiology
  • Aspergillus flavus / isolation & purification*
  • Endophthalmitis / etiology
  • Endophthalmitis / pathology
  • Endophthalmitis / therapy*
  • Farmer's Lung / drug therapy*
  • Farmer's Lung / etiology
  • Humans
  • Inflammation
  • Injections, Intraocular
  • Injections, Intravenous
  • Male
  • Treatment Outcome
  • Vision, Low / etiology
  • Vision, Ocular*
  • Visual Acuity
  • Vitrectomy
  • Vitreous Body / microbiology
  • Vitreous Body / pathology
  • Vitreous Body / surgery

Substances

  • Antifungal Agents
  • Amphotericin B