Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management

Purpose: To present a case of fungal endophthalmitis with a novel organism and our management. Observations: A 46 year old male presented with delayed-onset acute endophthalmitis 6 weeks after routine phacoemulsification and intraocular lens implantation. Initial treatment with intravitreal antibiot...

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Main Authors: Shong Min Voon, Arlo Upton, Deepak Gupta
Format: Article
Language:English
Published: Elsevier 2019-09-01
Series:American Journal of Ophthalmology Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S245199361830402X
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author Shong Min Voon
Arlo Upton
Deepak Gupta
author_facet Shong Min Voon
Arlo Upton
Deepak Gupta
author_sort Shong Min Voon
collection DOAJ
description Purpose: To present a case of fungal endophthalmitis with a novel organism and our management. Observations: A 46 year old male presented with delayed-onset acute endophthalmitis 6 weeks after routine phacoemulsification and intraocular lens implantation. Initial treatment with intravitreal antibiotics did not improve his condition. With repeated vitreal taps, the causative organism was eventually identified as a fungus, Pseudozyma aphidis. Treatment with oral and intravitreal voriconazole, as well as pars plana vitrectomy, led to resolution of the endophthalmitis and recovery of vision to 20/25. Conclusions and importance: Fungal endophthalmitis is a rare, potentially blinding complication of cataract surgery. We report our approach to this previously unreported organism, that led to an excellent visual outcome. There are no specific guidelines for fungal endophthalmitis. The management approach has to be tailored to the clinical response and emerging laboratory data from the microbiologist. Identification of the organism will require specialist laboratory references that may not be available in all hospitals. Ophthalmologists must work closely with microbiologists in order to ensure an optimal outcome. Keywords: Pseudozyma aphidis, Fungal endophthalmitis, Exogenous, Management
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spelling doaj.art-71bcec4f16024bf1bc643b9bfb5820402022-12-21T18:42:11ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362019-09-0115Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and managementShong Min Voon0Arlo Upton1Deepak Gupta2Department of Ophthalmology, Dunedin Public Hospital, 201 Great King Street, Dunedin, 9016, Otago, New Zealand; Corresponding author.Southern Community Laboratories, Dunedin, 9016, Otago, New ZealandDepartment of Ophthalmology, Dunedin Public Hospital, 201 Great King Street, Dunedin, 9016, Otago, New ZealandPurpose: To present a case of fungal endophthalmitis with a novel organism and our management. Observations: A 46 year old male presented with delayed-onset acute endophthalmitis 6 weeks after routine phacoemulsification and intraocular lens implantation. Initial treatment with intravitreal antibiotics did not improve his condition. With repeated vitreal taps, the causative organism was eventually identified as a fungus, Pseudozyma aphidis. Treatment with oral and intravitreal voriconazole, as well as pars plana vitrectomy, led to resolution of the endophthalmitis and recovery of vision to 20/25. Conclusions and importance: Fungal endophthalmitis is a rare, potentially blinding complication of cataract surgery. We report our approach to this previously unreported organism, that led to an excellent visual outcome. There are no specific guidelines for fungal endophthalmitis. The management approach has to be tailored to the clinical response and emerging laboratory data from the microbiologist. Identification of the organism will require specialist laboratory references that may not be available in all hospitals. Ophthalmologists must work closely with microbiologists in order to ensure an optimal outcome. Keywords: Pseudozyma aphidis, Fungal endophthalmitis, Exogenous, Managementhttp://www.sciencedirect.com/science/article/pii/S245199361830402X
spellingShingle Shong Min Voon
Arlo Upton
Deepak Gupta
Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management
American Journal of Ophthalmology Case Reports
title Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management
title_full Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management
title_fullStr Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management
title_full_unstemmed Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management
title_short Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management
title_sort pseudozyma aphidis endophthalmitis post cataract operation case discussion and management
url http://www.sciencedirect.com/science/article/pii/S245199361830402X
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AT deepakgupta pseudozymaaphidisendophthalmitispostcataractoperationcasediscussionandmanagement