Endogenous Fungal Endophthalmitis Research Articles

Endogenous <i>Aspergillus</i> Endophthalmitis Associated with Periodontitis

We report a 64-year-old woman who developed endogenous endophthalmitis in the course of severe periodontitis. Histopathological examination of the vitreous debris obtained during vitrectomy disclosed fungi and its culture identified Aspergillus flavus. Periodontitis should be considered as one of the infectious foci for endogenous fungal endophthalmitis as well as bacterial endophthalmitis.

Endogenous Endophthalmitis Due to Fusarium: Case Report and Review

Endogenous fungal endophthalmitis is being increasingly recognized in susceptible individuals. We report a case of endogenous endophthalmitis due to Fusarium solani that occurred as the sole clinical manifestation of fungal disease in an immunocompromised host. Four previously reported cases of endogenous fusarial endophthalmitis are also reviewed. Two of these patients had no underlying disease and presented with isolated endophthalmitis, while two other patients had acute leukemia and presented with multiple organ involvement due to Fusarium. All three patients with leukemia, including our patient, were severely neutropenic at the time of diagnosis. Two of these three patients had fungemia. MICs of amphotericin B for fungal isolates ranged from 0.14 to 10 micrograms/mL. Despite abatement of the endophthalmitis after antifungal therapy and vitrectomy, the prognosis for immunocompromised patients remains guarded because of underlying disease.

Screening for Fungal Endophthalmitis in Children at Risk

To evaluate the efficacy of screening ophthalmologic examinations in high-risk children, we reviewed the medical records for all patients hospitalized from 1985 through 1989 at The Hospital for Sick Children, Toronto, Ontario, who underwent ophthalmological consultation to rule out endogenous fungal endophthalmitis (n = 176). The patients were divided into groups: Group 1 (n = 47), those with deep-tissue fungal infection, and Group 2 (n = 129), those at risk for invasive fungal disease. Group 2 was subdivided further into two subgroups: Group 2a (n = 48), those with evidence of superficial fungal colonization (positive fungal culture) but no deep-tissue involvement, and Group 2b (n = 81), those with no evidence of fungal colonization (negative fungal culture). Of these 176 patients, 7 were diagnosed with endogenous fungal endophthalmitis: 6 from Group 1, 1 from Group 2a, and 0 from Group 2b. We found a significant association between the development of endogenous fungal endophthalmitis and the status of the fungal culture result (P less than .005). The odds ratio indicated the risk of endogenous fungal endophthalmitis in Group 1 patients with deep-tissue infection was at least 19 times that of Group 2 at-risk patients. The risk of endogenous fungal endophthalmitis in Group 1 patients was at least 7 times that of Group 2a colonized patients and 12 times that of Group 2b patients with no positive fungal culture. Our study confirms the necessity of careful dilated ophthalmoscopic examination in patients with invasive fungal disease and suggests screening for those at-risk patients with superficial fungal colonization.(ABSTRACT TRUNCATED AT 250 WORDS)

Endogenous Fungal Endophthalmitis in a Drug Addict

Endogenous Fungal Endophthalmitis in a Drug Addict

Endogenous Aspergillus endophthalmitis in a healthy individual

Fungal endogenous endophthalmitis in a healthy individual without any predisposing factors is very uncommon. It can occur in intravenous drug abusers, where Aspergillus is more frequently isolated as the causative organism. We treated an unusual case of culture-proven endogenous Aspergillus endophthalmitis who was immunocompetent and was not an intravenous drug user. The affected eye was successfully treated with repeated intravitreal, intracameral and intrastromal injections of amphotericin B and anterior chamber wash. Endogenous fungal endophthalmitis can occur in healthy individuals.