Department of Ophthalmology, Virgen Del Rocío University Hospital, Seville, Spain.
Ocul Immunol Inflamm. 2023 Sep;31(7):1519-1521. doi: 10.1080/09273948.2022.2123834. Epub 2022 Sep 27.
We describe the case of a postoperative fungal endophthalmitis caused by , an opportunistic yeast common in nature but rare as a causative agent in ocular infections. This would be the second reported case of endophthalmitis.
A patient came to our hospital with a dense hemovitreous caused by an inadvertent ocular perforation and retinal detachment during a cataract surgery. In the days following the first vitreoretinal surgery a chronic postoperative endophthalmitis was evidenced. Only after several surgeries as well as intravitreal antibiotics and sample takings, was detected. The treatment with oral voriconazole and an intraocular lens extraction controlled the infection.
, despite not being particularly aggressive in our case, was resistant to various consequent vitreoretinal surgeries. The unresponsiveness to treatment led us to contemplate the fungal etiology, and fortunately the cultures were positive for this yeast. In conjunction to antifungal therapy, it is possible that the IOL explantation played an important role in the treatment.
A high index of suspicion must be held in cases of fungal endophthalmitis. Both IOL explantation and oral antifungal therapy are useful treatment options in cases of endophthalmitis.
我们描述了一例由 引起的术后真菌性眼内炎病例。 是一种常见于自然界的机会性酵母,但作为眼部感染的病原体却很少见。这将是第二例报道的 眼内炎病例。
一名患者因白内障手术中意外发生眼穿孔和视网膜脱离,导致密集的玻璃体积血,来到我院就诊。在第一次玻璃体视网膜手术后的几天内,出现了慢性术后眼内炎。只有经过多次手术以及玻璃体内抗生素和样本采集后,才检测到 。口服伏立康唑和人工晶状体取出术控制了感染。
尽管 在我们的病例中并不特别具有侵袭性,但对各种随后的玻璃体视网膜手术具有耐药性。治疗的无反应促使我们考虑真菌病因,幸运的是,该酵母的培养结果为阳性。除了抗真菌治疗外,人工晶状体取出术可能在治疗中发挥了重要作用。
对于真菌性眼内炎,必须保持高度怀疑。对于 眼内炎病例,人工晶状体取出术和口服抗真菌治疗都是有效的治疗选择。