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Subconjunctival mycetoma after sub-Tenon's corticosteroid injection
Anat Galor1, Carol L Karp, Richard K Forster
1Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA.
Cornea
|August 6, 2009
Summary
A rare subconjunctival mycetoma caused by Exophiala jeanselmei developed in a patient after a corticosteroid injection. This case highlights a potential fungal infection risk following sub-Tenon
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Sub-Tenon's injections of triamcinolone acetonide are common for treating posterior segment ocular conditions like wet age-related macular degeneration.
- Corticosteroid injections can potentially increase the risk of infection due to their immunosuppressive effects.
- Mycetoma are chronic, localized infections typically affecting the skin and subcutaneous tissue, often caused by fungi or bacteria.
Observation:
- A 76-year-old male presented with a subconjunctival mass.
- The mass appeared in the area of a prior posterior sub-Tenon's triamcinolone acetonide injection.
- The patient had a history of wet age-related macular degeneration treated with the injection.
Findings:
- Microbiologic and pathologic analysis identified the causative agent as Exophiala jeanselmei, a pigmented fungus.
- The diagnosis was subconjunctival mycetoma, a rare presentation.
- This represents the first reported instance of an Exophiala-associated subconjunctival mycetoma.
Implications:
- This case underscores the possibility of fungal infections, specifically mycetoma, occurring after sub-Tenon's corticosteroid injections.
- Ophthalmologists should consider fungal etiologies in the differential diagnosis of subconjunctival masses following such procedures.
- Further vigilance and diagnostic awareness are crucial for timely and appropriate management of post-injection complications.
