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Delayed-onset fungal keratitis after endophthalmitis
D J Weissgold1, S E Orlin, M E Sulewski
1Department of Ophthalmology, University of Vermont College of Medicine, Burlington, USA.
Ophthalmology
|February 28, 1998
Summary
Delayed fungal keratitis can occur after endophthalmitis treatment. Prolonged monitoring and prompt re-treatment are crucial for managing these persistent fungal eye infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Mycology
Background:
- Cataract surgery can lead to fungal endophthalmitis.
- Aggressive antifungal therapy is the standard treatment for fungal endophthalmitis.
Observation:
- Two patients developed delayed-onset, deep stromal fungal keratitis weeks to months after seemingly successful treatment for fungal endophthalmitis.
- Despite intensive systemic and topical antifungal treatment, keratitis worsened in both cases.
Findings:
- Fungal organisms, including Fusarium solani and Acremonium kiliense, were implicated.
- Therapeutic penetrating keratoplasty was required for infection resolution in one patient.
- One patient experienced a severe complication of expulsive choroidal hemorrhage during corneal transplantation.
Implications:
- Fungal endophthalmitis may require prolonged monitoring due to the risk of late recrudescence.
- Early detection and re-initiation of antifungal treatment are vital for managing recurrent fungal keratitis.
- This highlights the importance of long-term follow-up in patients treated for fungal endophthalmitis.
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