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Delayed-onset postoperative endophthalmitis secondary to Exophiala

Jose Alberto Quintero-Estades1, Scott Walter2, Felipe Valenzuela2

  • 1University of Puerto Rico School of Medicine, San Juan, Puerto Rico.

BMJ Case Reports
|February 19, 2015
PubMed

Insights

This study reports a rare case of delayed-onset Exophiala endophthalmitis. Surgical intervention combined with intravitreal voriconazole offers a promising treatment for this challenging fungal eye infection.

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Exophiala fungi are slow-growing, melanin-producing organisms typically found in soil and decaying matter.
  • These fungi can cause various ophthalmic conditions, including keratitis, scleritis, and endophthalmitis.

Observation:

  • A rare case of delayed-onset postoperative endophthalmitis, localized to the anterior segment, caused by Exophiala species is presented.
  • Previous treatments for similar cases have yielded suboptimal outcomes with medical management alone.

Findings:

  • Surgical removal of the infected tissue (nidus) is crucial for managing this condition.
  • Combining anterior segment surgery with intravitreal voriconazole effectively treated the infection and prevented recurrence.

Implications:

  • This approach offers a superior alternative to medical management for delayed-onset Exophiala endophthalmitis.
  • Early surgical intervention is key to successful outcomes in these rare fungal eye infections.
  • Highlights the importance of considering fungal pathogens in delayed postoperative endophthalmitis.

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