[Endophthalmitis caused by Paecilomyces lilacinus after cataract surgery: a case report]

A case of fungal endophthalmitis caused by Paecilomyces lilacinus after cataract surgery is reported. An 84-year-old woman had been suffering from diabetes mellitus and hypertension. She underwent an uncomplicated extracapsular cataract extraction with implantation of a posterior chamber intraocular lens in the right eye. Approximately one month after the surgery iritis was noted, and treated systemically and topically with corticosteroids and antibiotics. The inflammation was improved by these therapies at first, but worsened when the dose of oral corticosteroid was reduced. White fluffy exudates were present on the iris near the chamber angle with the hypopyon. Removal of the intraocular lens, vitrectomy and medicinal therapy were undertaken. The eye was salvaged but the final visual acuity was counting fingers. Paecilomyces lilacinus was identified from the intraocular specimen taken at the time of surgery. The clinical effects and the results of in-vitro sensitivity test showed that fluconazole and amphotericin B were ineffective, and that econazole, thimerosal and miconazole were effective.