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L Simon1, L Gastaud2, D Martiano3

  • 1Laboratoire de parasitologie-mycologie, hôpital de l'Archet, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine-de-Ginestière CS 23079, 06202 Nice cedex 3, France.

Insights

This study reports the first case of endogenous fungal endophthalmitis caused by Fusarium dimerum in an acute myeloid leukemia patient. Prompt treatment with voriconazole and amphotericin B controlled the rare eye infection.

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Endophthalmitis is a severe intraocular infection, with fungal forms posing significant treatment challenges due to poor antifungal penetration and emerging resistance.
  • Fusarium species are common soil and plant pathogens, rarely implicated in endogenous endophthalmitis.

Purpose of the Study:

  • To describe the first documented case of endogenous fungal endophthalmitis caused by Fusarium dimerum.
  • To highlight the diagnostic and therapeutic approach for this rare clinical entity.

Main Methods:

  • A case report of a 71-year-old female patient with acute myeloid leukemia undergoing chemotherapy.
  • Diagnosis was confirmed via vitrectomy, identifying fungal hyphae and positive cultures for Fusarium dimerum.
  • Treatment involved intravitreal voriconazole and amphotericin B, plus systemic voriconazole.

Main Results:

  • The patient developed endogenous fungal endophthalmitis due to Fusarium dimerum, despite antifungal prophylaxis.
  • Vitrectomy was crucial for diagnosis, revealing fungal hyphae and enabling pathogen identification.
  • Combined intravitreal and systemic antifungal therapy achieved complete infection control.

Conclusions:

  • Fusarium dimerum can cause endogenous endophthalmitis, even with antifungal prophylaxis, particularly in immunocompromised patients.
  • Aggressive and timely treatment with voriconazole and amphotericin B is essential for managing this sight-threatening condition.
  • Despite successful infection control, significant retinal damage resulted in vision loss.

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