Bilateral Aspergillus endophthalmitis following cataract surgery: a diagnostic and therapeutic challenge-a case report.

BACKGROUND

Here we describe a case of bilateral Aspergillus endophthalmitis occurring 4 months after bilateral cataract surgery, manifesting as a spectacular filamentary branching on the intraocular lens/capsular surface and difficulties in treatment.

CASE PRESENTATION

A 66-year-old Iranian male patient with a known case of chronic lymphocytic leukemia, who had previously undergone bilateral cataract surgery during the same session 4 months before, presented with a bilateral decrease in vision and vitreous haziness. The cytopathology results from vitreous sampling were negative for dysplastic cells. Still, the polymerase chain reaction analysis showed a positive result for Aspergillus sp., and a unique, striking filamentary branching growth appeared on the intraocular lens/capsular surface in both eyes. Treatment was challenging, with multiple vitrectomies and systemic and intravitreal anti-fungal agent treatment.

CONCLUSION

Challenges in managing bilateral Aspergillus endophthalmitis after cataract surgery in immunocompromised patients, diagnosis difficulties, voriconazole resistance, and the importance of early intervention are highlighted.