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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.

Journal De Mycologie Medicale
|February 26, 2018
PubMed
Summary
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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.
Keywords:
EndophthalmitisFusariumImmunocompromisedLeukemiaVitrectomyVoriconazole

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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.