[Severe Aspergillus endophthalmitis occurring after liver transplantation in an 8-month-old baby]

Area of Science:

• Ophthalmology
• Infectious Diseases
• Transplantation Medicine

Background:

• Immunosuppressed and transplant recipients are at elevated risk for invasive fungal infections, including invasive aspergillosis.
• Aspergillus endophthalmitis, a severe intraocular infection, can lead to significant vision loss and systemic dissemination.

Observation:

• An 8-month-old boy, who had undergone a liver transplantation, presented with severe unilateral panuveitis.
• The patient exhibited bronchopulmonary infiltrates, suggestive of a fungal infection, though Aspergillus was not definitively confirmed in the lungs.

Findings:

• Despite the absence of confirmed pulmonary Aspergillus infection, the clinical presentation of severe panuveitis post-transplantation raised strong suspicion.
• Enucleation of the affected eye was performed as a critical measure to prevent the potential life-threatening complication of disseminated Aspergillus infection.

Implications:

• This case underscores the importance of vigilant monitoring for opportunistic infections, particularly Aspergillus, in pediatric transplant recipients.
• Early recognition and aggressive management, including consideration of enucleation, are crucial in preventing fatal systemic aspergillosis in immunocompromised patients.
• Ophthalmologists and transplant teams must collaborate closely to manage complex cases of suspected Aspergillus endophthalmitis in this vulnerable population.