Endogenous Fusarium Endophthalmitis in Diabetes Mellitus

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Endogenous endophthalmitis constitutes 2-8% of all endophthalmitis cases.
• Mold fungi, including Aspergillus, Fusarium, and Scedosporium, are common causes in immunocompromised individuals and intravenous drug users.
• Diabetes mellitus is a known risk factor for endogenous endophthalmitis.

Purpose of the Study:

• To report a unique case of Fusarium endophthalmitis in a patient with uncontrolled diabetes mellitus.
• To highlight the presentation of Fusarium endophthalmitis as a masquerade syndrome mimicking noninfectious uveitis.
• To emphasize the importance of recognizing uncontrolled diabetes as a risk factor for this specific fungal endophthalmitis.

Main Methods:

• Case report of a patient with uncontrolled diabetes mellitus presenting with endophthalmitis.
• Clinical evaluation including ophthalmological examination and assessment of response to treatment.
• Review of literature for similar cases of Fusarium endophthalmitis associated with diabetes.

Main Results:

• The patient presented with granulomatous uveitis, initially responding well to steroids, mimicking noninfectious uveitis.
• Characteristic clinical features of Fusarium endophthalmitis became apparent late in the disease course.
• The outcome was poor due to the delayed diagnosis and characteristic presentation.

Conclusions:

• Uncontrolled diabetes mellitus is a significant, though underreported, risk factor for Fusarium endophthalmitis.
• Fusarium endophthalmitis can present as a masquerade syndrome, delaying diagnosis and treatment.
• A high index of suspicion is necessary for clinicians to ensure timely diagnosis and improve outcomes in such cases.