Aspergillus Endophthalmitis Resulting in Development of Retinal Aspergilloma

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Endogenous endophthalmitis is a severe intraocular infection, often bacterial.
• Fungal endophthalmitis is rare, particularly in immunocompetent individuals.

Observation:

• A 78-year-old immunocompetent male presented with decreased vision and panuveitis.
• A macular lesion, initially presumed to be bacterial endophthalmitis, enlarged and caused tractional retinal detachment.
• Initial fungal cultures were dismissed as contaminants.

Findings:

• Surgical resection revealed an invasive retinal aspergilloma.
• Polymerase chain reaction and histopathology confirmed Aspergillus fumigatus infection.
• The patient had received extensive antibiotic and antifungal treatment without resolution.

Implications:

• This case highlights the importance of considering fungal pathogens in endogenous endophthalmitis, even in immunocompetent hosts.
• Aggressive surgical management may be necessary for invasive fungal retinal infections.
• Accurate laboratory identification is crucial to avoid misdiagnosis of fungal contaminants.