Abstract
IntroductionEndogenous Fusarium endophthalmitis is a rare disease predominantly described in immunocompromised patients often due to leukemia. We report a case of bilateral endogenous Fusarium solani endophthalmitis in a liver-transplanted patient.Case presentationA 56-year-old Danish Caucasian woman who had undergone two liver transplantations, developed endogenous endophthalmitis of her left eye 10 days after the second liver transplantation. Despite continuous therapy, enucleation of her left eye was eventually necessary; at this point funduscopic examination of her right eye disclosed a white inflammatory plaque at the macula consistent with a fungal infection. Microbiological analysis of vitreous fluid from her enucleated left eye revealed Fusarium solani, and light microscopy of her enucleated eye was consistent with Fusarium panophthalmitis with massive ingrowth of the fungi in all areas containing basement membrane collagen. Voriconazole was injected intravitreally in her right eye, and intravenous voriconazole was initiated. No subsequent growth in the inflammatory plaque was observed. She died 6 weeks after the endogenous endophthalmitis was diagnosed.ConclusionsThis is the first report of endogenous Fusarium solani endophthalmitis in a liver-transplanted patient. Ophthalmologists and physicians dealing with liver transplantation should be aware of the potential for postoperative endophthalmitis due to rare microorganisms, such as Fusarium solani.
Highlights
Endogenous Fusarium endophthalmitis is a rare disease predominantly described in immunocompromised patients often due to leukemia
This is the first report of endogenous Fusarium solani endophthalmitis in a liver-transplanted patient
Ophthalmologists and physicians dealing with liver transplantation should be aware of the potential for postoperative endophthalmitis due to rare microorganisms, such as Fusarium solani
Summary
To the best of our knowledge, this is the first case of endogenous Fusarium solani endophthalmitis in a liver-transplanted patient; it emphasizes that unusual microbes should be considered a cause of endogenous endophthalmitis in immunocompromised patients. The immunosuppression of the patient was most probably the primary cause for this fulminant case of endophthalmitis. Consent Written informed consent was obtained from relatives of the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. Authors’ contributions JFK and JSJ were in charge of the ophthalmological care of the patient. JUP performed the histological examination of the eye. JSJ, JFK and JUP wrote the manuscript. All authors read and approved the final manuscript
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