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Fungal endophthalmitis caused by Aspergillus ustus in a patient following cataract surgery

Sinasi Taner Yildiran1, Fatih Mehmet Mutlu, Mehmet Ali Saracli

  • 1Division of Medical Mycology, Department of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey. sinasit@gata.edu.tr

Medical Mycology
|October 31, 2006
PubMed

Insights

A rare Aspergillus ustus fungal infection caused severe endophthalmitis after cataract surgery. Despite aggressive antifungal treatment, the patient

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Postoperative endophthalmitis is a serious complication following cataract surgery.
  • Fungal endophthalmitis, though less common than bacterial, presents significant treatment challenges.

Observation:

  • A 67-year-old diabetic patient developed uveitis six weeks post-cataract surgery.
  • Clinical signs included ciliary injection and ocular discomfort, progressing despite interventions.

Findings:

  • Cultures confirmed Aspergillus ustus, a rarely pathogenic fungus, as the causative agent.
  • The infection was refractory to systemic and intravitreal antifungal therapies, including amphotericin B and caspofungin.
  • In vitro testing revealed resistance to multiple antifungals, with terbinafine susceptibility.

Implications:

  • This case highlights the potential for rare fungal species to cause severe postoperative endophthalmitis.
  • Treatment strategies for resistant fungal endophthalmitis may require novel approaches.
  • Understanding antifungal susceptibility patterns is crucial for managing refractory cases.

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