Trichosporon Endophthalmitis Following Cataract Surgery: A Case Report

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Fungal endophthalmitis, particularly from Trichosporon inkin, presents diagnostic and therapeutic challenges.
• Endogenous infections are more common in immunocompromised patients, but exogenous cases can occur post-ophthalmic surgery.

Observation:

• A 51-year-old diabetic patient developed severe endophthalmitis after cataract surgery.
• Initial treatments with antibiotics and steroids were ineffective, and vitreous cultures were negative.
• Intraocular lens explantation revealed Trichosporon inkin.

Findings:

• Successful treatment of exogenous Trichosporon inkin endophthalmitis was achieved.
• Combined therapy included voriconazole (topical, intravitreal, systemic), pars plana vitrectomy, and explantation of the infected intraocular lens.
• Minimum inhibitory concentration-guided antifungal sensitivity testing informed treatment selection.

Implications:

• This case demonstrates the importance of considering fungal causes in persistent post-operative endophthalmitis.
• Aggressive surgical intervention combined with targeted antifungal therapy can lead to favorable visual outcomes.
• Early diagnosis and appropriate management are crucial for salvaging vision in fungal endophthalmitis.