İmmün Direnci Yerinde Bir Hastada Katarakt Cerrahisinden Sonra Aspergillus terreus ve Aspergillus fumigatus Nedeniyle Gelişen Karma Fungal Endoftalmit

Abstract

A 55-year-old, otherwise healthy woman was referred to our clinic for pars plana vitrectomy with the diagnosis of fungal endophthalmitis due to Aspergillus fumigatus in her right eye. Five months earlier, she had undergone cataract surgery elsewhere. Ten days before presentation to our clinic she was hospitalized in another clinic with the diagnosis of fungal endophthalmitis and she received systemic and intravitreal voriconazole therapy. Pars plana vitrectomy could not be performed due to hazy cornea. Aspergillus terreus was isolated from the anterior chamber aspirate in our institution; thus mixed fungal infection due to Aspergillus terreus and Aspergillus fumigatus was considered in this case. Despite appropriate intravitreal and systemic antifungal therapy ocular condition continued to deteriorate and unfortunately, the eye was eviscerated. In resistant endophthalmitis, fungi (especially Aspergillus species) should be considered even in non-immunocompromised cases. In such cases, steroids must be avoided and early pars plana vitrectomy is recommended.