Abstract
BackgroundThere are very few reports of Aspergillus fumigatus causing endogenous endophthalmitis (EAE) in immunocompetent individuals although it is well recognised in the immunocompromised. Treatment can be with intravitreal, intravenous and oral antifungal agents. The benefit of an oral agent is clear however the concentration of voriconazole in the inflamed eye after oral administration has not previously been documented.Case presentationWe present a case of EAE in an immunocompetent 78-year-old Caucasian female who was subsequently managed with oral voriconazole. Using a bioassay, we show an appropriate voriconazole concentration in serum and vitreous samples.ConclusionThis case adds to the limited literature on the prevalence of endogenous endophthalmitis in immunocompetent patients and supports the use of voriconazole in such cases.
Highlights
There are very few reports of Aspergillus fumigatus causing endogenous endophthalmitis (EAE) in immunocompetent individuals it is well recognised in the immunocompromised
This case adds to the limited literature on the prevalence of endogenous endophthalmitis in immunocompetent patients and supports the use of voriconazole in such cases
Endogenous Aspergillus Endophthalmitis (EAE) is a condition most commonly seen in patients who are immunosuppressed
Summary
Endogenous Aspergillus Endophthalmitis (EAE) is a condition most commonly seen in patients who are immunosuppressed. Case presentation A 78-year-old white caucasian lady presented to her local hospital with rapid loss of vision in her right eye over 12 hours She had been suffering from non-specific joint pains for several months for which she had been receiving acupuncture. She was commenced on oral voriconazole 400 mg twice a day for 24 hours as a loading dose The following day she complained of visual hallucinations at night, a wellknown side effect of the drug and the agent was discontinued for a day. On review two months later the uveitis had settled, but there was persistent pain and low intraocular pressure (4 mmHg) in the right eye indicating the onset of phthisis bulbi. Histological examination of the enucleated eye showed non-specific chronic fibrosing vitritis with no fungal elements seen using special stains
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