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Histoplasma capsulatum endophthalmitis after cataract extraction
J S Pulido1, R Folberg, K D Carter
1Department of Ophthalmology, University of Iowa Hospitals & Clinics, Iowa City 52242.
Ophthalmology
|February 1, 1990
Summary
A rare case of ocular Histoplasma infection occurred after eye surgery. This previously unreported form of exogenous postoperative Histoplasma endophthalmitis presented as severe inflammation despite treatment.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- A 60-year-old man with a history of chronic iritis and intraocular lens (IOL) removal presented with severe ocular inflammation.
- The patient resided in an area endemic for Histoplasma capsulatum.
Observation:
- The patient developed a vitreous wick, hypopyon iritis, and dense vitreitis.
- Diagnostic vitrectomy revealed Histoplasma capsulatum.
- Despite treatment with amphotericin and repeat vitrectomies, inflammation progressed, leading to enucleation.
Findings:
- Histopathological examination confirmed Histoplasma organisms on the vitreous wick, iris, ciliary body, and retina.
- Dalen-Fuchs-type nodules were observed, but without granulomatous inflammation.
- No organisms were detected in the choroid.
Implications:
- This case suggests a previously unreported form of exogenous postoperative Histoplasma endophthalmitis.
- The findings highlight the importance of considering fungal infections in postoperative endophthalmitis, especially in endemic areas.
- Unilateral disease with positive fungal cultures and negative serology can indicate localized ocular infection.