Bilateral endogenous Scedosporium prolificans endophthalmitis after lung transplantation

To report a case of bilateral endogenous fungal endophthalmitis resulting from disseminated Scedosporium prolificans. Observational case report. A 56-year-old woman with cystic fibrosis status post dual lung transplantation on chronic immunosuppressive therapy presented with acute graft rejection. C...

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Bibliographic Details
Published in:American journal of ophthalmology 2005-02, Vol.139 (2), p.370-373
Main Authors: Vagefi, M. Reza, Kim, Eleanore T., Alvarado, Richard G., Duncan, Jacque L., Howes, Ed L., Crawford, J. Brooks
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Biological and medical sciences
Chorioretinitis - microbiology
Endophthalmitis - diagnosis
Endophthalmitis - drug therapy
Endophthalmitis - microbiology
Eye Infections, Fungal - diagnosis
Eye Infections, Fungal - drug therapy
Eye Infections, Fungal - microbiology
Fatal Outcome
Female
Human mycoses
Humans
Immunocompromised Host
Immunosuppressive Agents - therapeutic use
Infectious diseases
Lung Transplantation
Medical sciences
Middle Aged
Mycetoma - diagnosis
Mycetoma - drug therapy
Mycetoma - microbiology
Mycoses
Mycoses of the eye and the orbit
Opportunistic Infections - diagnosis
Opportunistic Infections - drug therapy
Opportunistic Infections - microbiology
Scedosporium - isolation & purification
Vitreous Body - microbiology
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Summary:To report a case of bilateral endogenous fungal endophthalmitis resulting from disseminated Scedosporium prolificans. Observational case report. A 56-year-old woman with cystic fibrosis status post dual lung transplantation on chronic immunosuppressive therapy presented with acute graft rejection. Cultures of bronchial brushings revealed S. prolificans. Three weeks after admission, the patient noted increased blurriness and a central scotoma in her right eye. Dilated fundus examination revealed profound vitritis in the right eye with hemorrhagic retinitis involving the macula. A peripheral, yellow choroidal infiltrate with overlying retinitis and localized vitritis was present in the left eye. Intravitreal antibiotics were initiated, and vitreous cultures revealed S. prolificans. The patient ultimately succumbed to her disseminated disease. Pathologic examination of the eyes confirmed bilateral endogenous fungal endophthalmitis. S. prolificans is an opportunistic infection resistant to standard antifungal therapy that can result in endogenous endophthalmitis in immunocompromised individuals.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2004.08.005