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Bilateral endogenous Scedosporium prolificans endophthalmitis after lung transplantation
M Reza Vagefi1, Eleanore T Kim, Richard G Alvarado
1Department of Ophthalmology, University of California, San Francisco, California 94143-0730, USA.
Purpose:
To report a case of bilateral endogenous fungal endophthalmitis resulting from disseminated Scedosporium prolificans.
Design:
Observational case report.
Methods:
A 56-year-old woman with cystic fibrosis status post dual lung transplantation on chronic immunosuppressive therapy presented with acute graft rejection. Cultures of bronchial brushings revealed S. prolificans. Three weeks after admission, the patient noted increased blurriness and a central scotoma in her right eye. Dilated fundus examination revealed profound vitritis in the right eye with hemorrhagic retinitis involving the macula. A peripheral, yellow choroidal infiltrate with overlying retinitis and localized vitritis was present in the left eye.
Results:
Intravitreal antibiotics were initiated, and vitreous cultures revealed S. prolificans. The patient ultimately succumbed to her disseminated disease. Pathologic examination of the eyes confirmed bilateral endogenous fungal endophthalmitis.
Conclusion:
S. prolificans is an opportunistic infection resistant to standard antifungal therapy that can result in endogenous endophthalmitis in immunocompromised individuals.
