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Postoperative Rhizopus scleritis in a diabetic man
D H Locher1, A Adesina, T C Wolf
1Molecular Pathogenesis of Eye Infection Research Center, Dean A. McGee Eye Institute, Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Journal of Cataract and Refractive Surgery
|May 19, 1998
Summary
A diabetic patient developed a rare Rhizopus fungal infection of the sclera after cataract surgery. Despite aggressive treatment, globe destruction occurred, but the patient recovered fully within a year.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Cataract surgery, particularly with scleral tunnel incisions, can rarely lead to serious postoperative complications.
- Fungal infections, especially mucormycosis caused by Rhizopus species, pose a significant threat in immunocompromised individuals, including diabetics.
Observation:
- A 50-year-old diabetic male presented with necrotizing scleritis and keratitis four weeks post-cataract extraction.
- The infection rapidly progressed, causing severe destruction of the ocular globe.
Findings:
- Cultures from the necrotic sclera confirmed Rhizopus species infection.
- Despite comprehensive treatment with topical, subconjunctival, and intravenous amphotericin B, alongside hyperbaric oxygen therapy, the infection led to globe destruction.
- Histopathology of the enucleated globe confirmed Rhizopus infection.
Implications:
- This case highlights the potential for aggressive fungal infections following ocular surgery, even with initially uncomplicated procedures.
- Early recognition and aggressive management are crucial for fungal scleritis, though outcomes can be severe.
- Diabetic status is a critical risk factor for opportunistic fungal infections post-ophthalmic surgery.
