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Saprochaete clavata Chorioretinitis in a Post-chemotherapy Immunocompromised 9-Year-Old Child

Paul Goupillou1, Damien Costa2,3, Gilles Gargala2,3

  • 1Department of Ophthalmology, Rouen University Hospital, Rouen, France.

Ocular Immunology and Inflammation
|May 19, 2022
PubMed

Insights

This case report details managing bilateral chorioretinitis caused by Saprochaete clavata in a child with acute myeloid leukemia. Intravitreal voriconazole and amphotericin B were crucial for successful treatment and vision recovery.

Area of Science:

  • Ophthalmology
  • Mycology
  • Pediatric Oncology

Background:

  • Bilateral chorioretinitis is a severe ocular condition.
  • Saprochaete clavata is an opportunistic fungal pathogen.
  • Immunocompromised patients, particularly those undergoing chemotherapy, are at high risk for invasive fungal infections.

Observation:

  • A 9-year-old boy with acute myeloid leukemia developed fungemia due to Saprochaete clavata.
  • Ocular examination revealed progressive bilateral chorioretinitis.
  • Initial systemic treatment with voriconazole, amphotericin B, and flucytosine was insufficient.

Findings:

  • Bilateral intravitreal amphotericin B injections were administered.
  • Voriconazole blood concentrations were monitored and adjusted.
  • Visual acuity improved to 20/50 in the right eye and 20/20 in the left eye.

Implications:

  • This is the first reported case of chorioretinitis caused by Saprochaete clavata.
  • Therapeutic drug monitoring of voriconazole is essential in pediatric patients due to unpredictable pharmacokinetics.
  • Aggressive management including intravitreal therapy may be necessary for sight-threatening fungal endophthalmitis.
Abstract

Keywords:
ChorioretinitisGeotrichum clavatumSaprochaete clavatefungaemiauveitisvoriconazole

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