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Exophiala dermatitidis Eye Infection: Case Report and Literature Review
Suzana Otašević1,2, Marija Trenkić3,4, Marko Stalević5
1Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, 18000 Niš, Serbia.
Journal of Fungi (Basel, Switzerland)
|May 26, 2026
Summary
Exophiala endophthalmitis, a rare fungal eye infection, often follows ocular surgery and is difficult to diagnose. Voriconazole combined with surgery shows better outcomes than older treatments.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Exophiala endophthalmitis of exogenous origin is a rare but severe ocular infection.
- It is characterized by diagnostic delays, limited treatment options, and poor outcomes.
- A case of Exophiala dermatitidis endophthalmitis post-cataract surgery is presented.
Purpose of the Study:
- To report a new case of Exophiala endophthalmitis.
- To review and analyze previously reported cases of exogenous Exophiala endophthalmitis.
- To identify predisposing factors, diagnostic challenges, and treatment outcomes.
Main Methods:
- Case report of an 80-year-old woman with fungal keratitis and endophthalmitis.
- Microbiological (cultivation, microscopy, histopathology, PCR) identification of Exophiala dermatitidis.
- Systematic literature review of exogenous Exophiala endophthalmitis cases.
Main Results:
- Exophiala dermatitidis was identified as the causative agent in the presented case.
- Predisposing factors include ocular surgery, corneal disruption, diabetes, and corticosteroid use.
- Voriconazole with surgery showed better outcomes compared to Amphotericin B.
Conclusions:
- Exophiala endophthalmitis is underrecognized and challenging to manage.
- Early consideration in postoperative or trauma-associated inflammation is crucial.
- Azole-based therapy combined with surgical intervention is recommended.
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