Vitreo-Retina Services, Adarsh Super Speciality Eye Hospital, Shimoga, India.
Cataract and Refractive Services, Adarsh Super Speciality Eye Hospital, Shimoga, India.
BMJ Case Rep. 2022 May 11;15(5):e246637. doi: 10.1136/bcr-2021-246637.
A man in mid-50s presented with progressive blurred vision in his left eye for over 6 weeks. He was a known diabetic with history of COVID-19 pneumonia treated with steroids and remdesivir. He had pyelonephritis and urinary culture grown He was referred as a case of non-resolving vitreous haemorrhage. Visual acuity (VA) was hand movements with fundus showing dense vitritis. He underwent pars plana vitrectomy, vitreous biopsy with intraocular antibiotics (imipenem) suspecting as a case of endogenous bacterial endophthalmitis. Vitreous biopsy did not yield organisms on the smear/culture. The patient's condition worsened with perception of light and fundus showing dense vitritis with discrete yellowish white deposits on the surface of the retina. A repeat vitreous biopsy done along with intravitreal injection of voriconazole (suspecting fungal aetiology) grown fungal colonies and the organism was identified as At 4-month follow-up, the VA improved to 6/24.
一位 50 多岁的男性患者，左眼渐进性视力模糊超过 6 周。他是一名已知的糖尿病患者，曾因 COVID-19 肺炎接受类固醇和瑞德西韦治疗。他患有肾盂肾炎，尿液培养出 他被诊断为持续性玻璃体积血。视力为手动，眼底检查显示致密性眼内炎。他接受了经睫状体平坦部玻璃体切除术和玻璃体活检，并眼内注射了抗生素（亚胺培南），怀疑为内源性细菌性眼内炎。玻璃体活检在涂片/培养中均未发现病原体。患者的病情恶化，仅能感觉到光，眼底检查显示致密性眼内炎，视网膜表面有离散的黄白色沉积物。再次进行玻璃体活检和玻璃体内注射伏立康唑（怀疑为真菌病因），培养出真菌菌落，鉴定为 4 个月随访时，视力提高至 6/24。
