Abstract
Background: To report a successful treatment case of endogenous fungal endophthalmitis caused by corticosteroid impulse therapy and the cultures are always negative for fungi. Methods: Systemic antifungal treatment and full ophthalmic examination including B-scan ultrasonography, fundus photograph and indocyanine green angiography. Results: The visual acuity recovered from 0.2 to 0.8. B-scan ultrasonography revealed the largest irregular apophysis which disappeared finally. Both fundus photograph and indocyanine green angiography showed the chorioretinal lesions disappearing. Conclusion: Endogenous fungal endophthalmitis caused by corticosteroid impulse therapy is noteworthy and under this situation antifungal treatment should be considered even if the culture is negative for fungi.
Highlights
Endogenous fungal endophthalmitis (EFE) is a rare but serious complication of fungal sepsis and the incidence has increased in the past half century because of the advent of antibiotics and indwelling catheters [1]
We report, the successful management of fungal endophthalmitis in a patient with multiple diseases and unstable systemic status with oral voriconazole, but cerebral spinal fluid (CSF) and sputum cultures are always negative for fungi
Endogenous fungal endophthalmitis is less common, and it usually results from the hematogenous spread of fungi to the eye or, less commonly, spreading from the central nervous system to the eye via the optic nerve [1]
Summary
Endogenous fungal endophthalmitis (EFE) is a rare but serious complication of fungal sepsis and the incidence has increased in the past half century because of the advent of antibiotics and indwelling catheters [1]. Fungal endophthalmitis caused by the corticosteroid impulse therapy is less reported. We report, the successful management of fungal endophthalmitis in a patient with multiple diseases and unstable systemic status with oral voriconazole, but cerebral spinal fluid (CSF) and sputum cultures are always negative for fungi. Montage color fundus photograph showed macular subretinal mass, retinal surface covered with gray exudates from one to several disc diameters in size, accompanied by localized retinal detachment and peripheral choroidal detachment in the right eye in October 18, 2010 (Figure 1A).
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