1/18. Postmortem findings two weeks after oral treatment for metastatic Candida endophthalmitis with fluconazole.The purpose of this histological study was to present postmortem findings in both eyes of a 53-year-old male with liver dysfunction 2 weeks after short-time oral treatment with 200 mg/day fluconazole for metastatic Candida endophthalmitis due to intravenous hyperalimentation for 18 days. Candida had been demonstrated in the venous blood and on the tip of the intravenous catheter. The bilateral fungal endophthalmitis with hypopyon responded well to fungistatic therapy, but the patient suddenly died from heart failure. Both eyes were obtained at autopsy. Candida was demonstrated only in vitreous puff balls but not in the retina or uvea. fluconazole administered for a short period had little effect in eliminating fungus from vitreous puff balls, which have no blood supply. Prolonged administration of the antifungal drug or vitrectomy should be considered when treating an eye with vitreous puff balls in the presence of fungal endophthalmitis.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
2/18. Exogenous fungal endophthalmitis caused by paecilomyces.A 17-year-old white boy developed a fulminating corneal infection and endophthalmitis in his left eye after trauma. He was treated with antibiotics and corticosteroids for one week prior to diagnosis. A saprophytic fungus, paecilomyces viridis, was cultured from corneal scrapings and was demonstrated in the vitreous cavity by histopathologic examination.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
3/18. Postoperative mycobacterium chelonae endophthalmitis after extracapsular cataract extraction and posterior chamber intraocular lens implantation.OBJECTIVE: To describe a case of postoperative endophthalmitis caused by mycobacterium chelonae after extracapsular cataract extraction with posterior chamber intraocular lens implantation. DESIGN: Interventional case report. methods: The history and clinical presentation of a 66-year-old female patient, in whom a low-grade delayed-onset endophthalmitis and keratitis developed after extracapsular cataract extraction with posterior chamber intraocular lens implantation, is described. Microbiologic investigations of the scrapings of corneal infiltrate at the cataract incision site, aqueous humor and eviscerated material, and histopathologic study of eviscerated material and an enlarged cervical lymph node were performed. MAIN OUTCOME MEASURES: The clinical, histopathologic, and microbiologic findings in a case of low-grade delayed-onset endophthalmitis. RESULTS: Analysis of the direct smear of both the corneal infiltrate as well as the eviscerated material revealed acid-fast bacilli. M. chelonae was isolated from these specimens. Direct smear and culture of the aqueous humor were negative for bacteria (including mycobacteria) and fungus. Histopathologic examination of the eviscerated material showed a dense infiltration of polymorphonuclear leukocytes in the uveal tissue, extensive necrosis and hemorrhage, and exudates with hemorrhage in the vitreous cavity. Histopathologic examination of the lymph node revealed granulomatous inflammation with caseation necrosis, but did not reveal acid-fast bacilli. CONCLUSIONS: M. chelonae, although infrequent, should be considered an etiologic agent of delayed-onset, postoperative endophthalmitis and early bacterial diagnosis should help in institution of appropriate therapy.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
4/18. Mucor endophthalmitis.PURPOSE: To report on a case of type 2 diabetes, with eyelid gangrene and endophthalmitis as a presenting manifestation of rhino-orbito-cerebral mucormycosis. RESULTS: CECT head showed proptosis, mucosal thickening in the ethmoid sinus and hypodense lesions in the frontal and occipital lobes. Vitreous tap showed right angle branched aseptate hyphae consistent with mucormycosis. CONCLUSIONS: A diabetic patient presenting with sudden loss of vision, eyelid gangrene and endophthalmitis, involvement by an angio-invasive fungus-like mucormycosis is an important consideration.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
5/18. Clinicopathological report of Candida granuloma from an endogenous candidal endophthalmitis.fluconazole was reported to be an effective alternative to amphotericin b for candidal endophthalmitis. However, the dose for systemic use had not been determined and few pathological reports on its use have been published. An epiretinal membrane harvested from a regressed candidal endophthalmitis in a patient treated with fluconazole (200 mg/day) was sent for pathologic study. On the inner side of the retina, a granuloma was found. Fungal debris was found within the center of the granuloma, but an intact fungus was seen next to the granuloma. Pathologic study showed incomplete treatment in this case, although systemic status had improved. The use of systemic fluconazole should be maintained for a longer period of time to treat candidal endophthalmitis.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
6/18. Rapid molecular diagnosis of posttraumatic keratitis and endophthalmitis caused by alternaria infectoria.The first case of alternaria infectoria ocular infection is reported. keratitis and endophthalmitis developed after eye-perforating trauma from a lemon tree branch. Two months after surgery and empirical steroid and antibiotic treatment, diagnosis by molecular methods was performed. PCR amplification was positive for a fungus after 4 h. Antifungal treatment with amphotericin b and fluconazole was initiated immediately. dna sequence analysis showed alternaria infectoria to be the causal agent. After topical and systemic administration of antifungal treatment, ocular inflammation disappeared and visual acuity improved. dna typing was found to be a useful tool to achieve early identification of the causal agent.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
7/18. Cryptococcal endophthalmitis: case report and review.cryptococcus neoformans is an opportunistic fungus with a predilection for infecting the meninges. Ocular sequelae of cryptococcal infections of the CNS usually include cranial nerve palsies or papilledema secondary to increased intracranial pressure. Intraocular cryptococcosis occurs less frequently, and over the last 23 years, only 27 cases have been reported, including the case presented here. Intraocular infection was most often manifested by chorioretinal lesions and vitritis. Underlying diseases were detected in only 11 (41%) of the 27 patients. Of note, ocular lesions preceded symptomatic meningitis in six (27%) of 22 patients with CNS involvement. For seven patients, the diagnosis was made by histologic examination of specimens of aqueous or vitreous humor; for another eight patients, the diagnosis was made after enucleation or at autopsy. Ocular involvement frequently led to severe visual loss; return of vision to normal was unusual. Early recognition and treatment may improve outcome for these patients.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
8/18. Torulopsis candida (Candida famata) endophthalmitis simulating Propionibacterium acnes syndrome.Four months after undergoing extracapsular cataract extraction with implantation of a posterior chamber intraocular lens, a 74-year-old woman developed granulomatous anterior uveitis. Although she initially responded well to corticosteroid therapy, she experienced multiple recurrences on discontinuation of this therapy. Slit-lamp examination showed the ocular inflammation to be associated with white cortical material within the lens capsular sac. She underwent removal of the implant as well as the lens capsular sac. Anaerobic culture yielded no organisms, but fungus cultures yielded Torulopsis candida. Histopathologic and electron microscopic studies showed large numbers of yeast sequestered within the lens capsular sac and mild granulomatous inflammation around the sac. Torulopsis candida is occasionally isolated from specimens as a contaminant, but has not yet been shown to produce human disease. The case reported herein documents potential pathogenicity of Torulopsis candida and reveals the importance of organisms other than anaerobic bacteria in causing delayed and localized intraocular inflammation that is virtually identical to propionibacterium acnes infection.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
9/18. Surgical treatment for a case of postoperative pseudallescheria boydii endophthalmitis.pseudallescheria boydii (P. boydii) is an uncommon ocular pathogen which previously has been identified in only 10 of 905 fungal isolates identified by the Sid Richardson microbiology Laboratory at the Cullen eye Institute of Baylor College of medicine. Furthermore, only one case of postoperative P. boydii endophthalmitis and four cases of endogenous P. boydii endophthalmitis have been reported. Three of the four patients with endogenous endophthalmitis died within 4 weeks of diagnosis. We describe a second case of postoperative endophthalmitis due to this fungus. The infection was successfully eradicated following vitrectomy, corneoscleral resection, and patch graft, in addition to intraocular, topical, and oral antifungal medication. Although in vitro sensitivities are variable, P. boydii is known to be relatively resistant to amphotericin b. This points to the importance of proper cultures and sensitivities when treating cases of suspected fungal endophthalmitis. Unfortunately, the patient's eye became phthisical 6 months following the initial intervention.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
10/18. Infantile endogenous Candida endophthalmitis presenting as a cataract.The most common pathogen to cause endogenous endophthalmitis is the fungus candida albicans. Most cases involve adults who are either immunosuppressed or have a history of repeated or prolonged extracorporeal access to their circulatory system. Endogenous Candida endophthalmitis can occur in infants as well, particularly when prematurity, broad spectrum antibiotic therapy, or prior surgery are present as predisposing factors. We report the clinical and histopathological findings of an infant who developed a unilateral, sectoral lens opacity four months after undergoing treatment for disseminated candidiasis. The diagnosis of localized intralenticular fungal abscess with associated endophthalmitis was made via histopathologic examination of the aspirated lens material. Treatment with systemic antifungal agents successfully preserved the eye. In addition, we review and summarize the previously reported cases of Candida endophthalmitis in patients under one year of age.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
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