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Delayed-onset, bleb-associated endophthalmitis caused by Lecythophora mutabilis
Ingrid U Scott1, Vanessa Cruz-Villegas, Harry W Flynn
1Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Florida 33101, USA. iscott@bpei.med.miami.edu
American Journal of Ophthalmology
|March 12, 2004
Summary
This case report details a rare instance of delayed fungal endophthalmitis caused by Lecythophora mutabilis following glaucoma surgery. Treatment involved antifungal agents and surgical intervention, leading to successful infection resolution.
Area of Science:
- Ophthalmology
- Medical Mycology
- Infectious Diseases
Background:
- Delayed-onset endophthalmitis can occur after glaucoma surgery, particularly with filtering blebs.
- Lecythophora mutabilis is a rare fungal pathogen capable of causing severe intraocular infections.
Observation:
- A 57-year-old woman presented with delayed-onset endophthalmitis in her left eye, 8 years after trabeculectomy with Mitomycin C.
- The patient experienced pain and decreased vision, with cultures revealing Lecythophora mutabilis.
Findings:
- The fungal endophthalmitis was resistant to amphotericin B.
- Successful treatment involved intravitreal and systemic voriconazole, pars plana vitrectomy, iridectomy, and cryopexy.
Implications:
- This case highlights the importance of considering rare fungal pathogens in delayed endophthalmitis.
- Voriconazole demonstrates efficacy against Lecythophora mutabilis endophthalmitis, often requiring combined medical and surgical management.