Johari Mohammadkarim, Abuali Mostafa, Razavizadegan Seyed Ahmad, Moallem Mehdi
Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
J Med Case Rep. 2025 Jul 3;19(1):307. doi: 10.1186/s13256-025-05373-1.
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.
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.
Challenges in managing bilateral Aspergillus endophthalmitis after cataract surgery in immunocompromised patients, diagnosis difficulties, voriconazole resistance, and the importance of early intervention are highlighted.
在此我们描述一例双侧白内障手术后4个月发生的双侧曲霉菌性眼内炎病例，表现为眼内晶状体/囊膜表面出现显著的丝状分支以及治疗困难。
一名66岁的伊朗男性患者，已知患有慢性淋巴细胞白血病，4个月前在同一次手术中接受了双侧白内障手术，此次因双眼视力下降和玻璃体混浊就诊。玻璃体取样的细胞病理学结果显示发育异常细胞为阴性。然而，聚合酶链反应分析显示曲霉菌属呈阳性结果，且双眼的眼内晶状体/囊膜表面均出现了独特、显著的丝状分支生长。治疗具有挑战性，进行了多次玻璃体切除术以及全身和玻璃体内抗真菌药物治疗。
强调了免疫功能低下患者白内障手术后双侧曲霉菌性眼内炎管理中的挑战、诊断困难、伏立康唑耐药性以及早期干预的重要性。
