Exogenous Fungal Endophthalmitis: Clues to <i>Aspergillus</i> Aetiology with a Pharmacological Perspective

Exogenous fungal endophthalmitis (EXFE) represents a rare complication after penetrating ocular trauma of previously unresolved keratitis or iatrogenic infections, following intraocular surgery such as cataract surgery. The usual latency period between intraocular inoculation and presentation of sym...

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Bibliographic Details
Main Authors: Tommaso Lupia, Silvia Corcione, Antonio Maria Fea, Michele Reibaldi, Matteo Fallico, Francesco Petrillo, Marilena Galdiero, Silvia Scabini, Maria Sole Polito, Umberto Ciabatti, Francesco Giuseppe De Rosa
Format: Article
Language:English
Published: MDPI AG 2020-12-01
Series:Microorganisms
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Online Access:https://www.mdpi.com/2076-2607/9/1/74
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Summary:Exogenous fungal endophthalmitis (EXFE) represents a rare complication after penetrating ocular trauma of previously unresolved keratitis or iatrogenic infections, following intraocular surgery such as cataract surgery. The usual latency period between intraocular inoculation and presentation of symptoms from fungal endophthalmitis is several weeks to months as delayed-onset endophthalmitis. <i>Aspergillus</i> spp., is the most common causative mould pathogen implicated in this ocular infection and early diagnosis and prompt antimicrobial treatment, concomitantly in most cases with expert surgical attention, reduce unfavorable complications and increase the possibility of eye function preservation. Topical, intravitreal and systemic antifungal molecules are the mainstay of a medical approach to the disease and azoles, polyenes and in particular cases echinocandins are the pharmacological classes most commonly used in clinical practice. This review discusses pharmacokinetics and pharmacodynamic of antifungal agents in their principal modes of administration with a focus on their ability to achieve high drug concentration in the vitreous and ocular tissues.
ISSN:2076-2607