Abstract
Purpose: To describe a patient with late post-operative endophthalmitis and clear cornea tunnel infection caused by Candida parapsilosis that was masquerading as chronic anterior uveitis. Observations: A 62-year old woman with history of uncomplicated cataract surgery 7 months prior and chronic postoperative anterior uveitis, presented with an endothelial plaque, hypopyon, and infiltrates in the capsular bag and within the clear corneal tunnel. Anterior chamber cultures identified C. parapsilosis and pathology of the endothelial plaque showed fungus. Anterior chamber washout, scraping of the endothelial plaque, serial intracameral and intravitreal injections with amphotericin B (10 mcg) failed to control the infection. Pars plana vitrectomy, removal of the intraocular lens and capsular bag, a corneal patch graft, and administration of intravitreal antifungal agents were performed. One year later the patient remains free of recurrence and her best-corrected vision is 20/25 with a rigid gas permeable contact lens. Conclusions: and Importance: Persistent intraocular and intracorneal inflammation after cataract surgery should raise suspicion of endophthalmitis caused by fungi non-responsive to topical and intravitreal antibiotics. Surgical intervention and removal of the nidus of infection, which is often the intraocular lens and capsular bag, may be necessary for a successful outcome.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 109-114 |
| Number of pages | 6 |
| Journal | American Journal of Ophthalmology Case Reports |
| Volume | 11 |
| DOIs | |
| State | Published - Sep 1 2018 |
Fingerprint
Keywords
- Amphotericin B
- Clear corneal tunnel infection
- Fungal endophthalmitis
- Intravitreal antifungals
- Voriconazole
ASJC Scopus subject areas
- Ophthalmology
Cite this
Delayed-onset Candida parapsilosis cornea tunnel infection and endophthalmitis after cataract surgery : Histopathology and clinical course. / Palioura, Sotiria; Relhan, Nidhi; Leung, Ella; Chang, Victoria; Yoo, Sonia H; Dubovy, Sander; Flynn, Harry W.
In: American Journal of Ophthalmology Case Reports, Vol. 11, 01.09.2018, p. 109-114.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Delayed-onset Candida parapsilosis cornea tunnel infection and endophthalmitis after cataract surgery
T2 - Histopathology and clinical course
AU - Palioura, Sotiria
AU - Relhan, Nidhi
AU - Leung, Ella
AU - Chang, Victoria
AU - Yoo, Sonia H
AU - Dubovy, Sander
AU - Flynn, Harry W
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Purpose: To describe a patient with late post-operative endophthalmitis and clear cornea tunnel infection caused by Candida parapsilosis that was masquerading as chronic anterior uveitis. Observations: A 62-year old woman with history of uncomplicated cataract surgery 7 months prior and chronic postoperative anterior uveitis, presented with an endothelial plaque, hypopyon, and infiltrates in the capsular bag and within the clear corneal tunnel. Anterior chamber cultures identified C. parapsilosis and pathology of the endothelial plaque showed fungus. Anterior chamber washout, scraping of the endothelial plaque, serial intracameral and intravitreal injections with amphotericin B (10 mcg) failed to control the infection. Pars plana vitrectomy, removal of the intraocular lens and capsular bag, a corneal patch graft, and administration of intravitreal antifungal agents were performed. One year later the patient remains free of recurrence and her best-corrected vision is 20/25 with a rigid gas permeable contact lens. Conclusions: and Importance: Persistent intraocular and intracorneal inflammation after cataract surgery should raise suspicion of endophthalmitis caused by fungi non-responsive to topical and intravitreal antibiotics. Surgical intervention and removal of the nidus of infection, which is often the intraocular lens and capsular bag, may be necessary for a successful outcome.
AB - Purpose: To describe a patient with late post-operative endophthalmitis and clear cornea tunnel infection caused by Candida parapsilosis that was masquerading as chronic anterior uveitis. Observations: A 62-year old woman with history of uncomplicated cataract surgery 7 months prior and chronic postoperative anterior uveitis, presented with an endothelial plaque, hypopyon, and infiltrates in the capsular bag and within the clear corneal tunnel. Anterior chamber cultures identified C. parapsilosis and pathology of the endothelial plaque showed fungus. Anterior chamber washout, scraping of the endothelial plaque, serial intracameral and intravitreal injections with amphotericin B (10 mcg) failed to control the infection. Pars plana vitrectomy, removal of the intraocular lens and capsular bag, a corneal patch graft, and administration of intravitreal antifungal agents were performed. One year later the patient remains free of recurrence and her best-corrected vision is 20/25 with a rigid gas permeable contact lens. Conclusions: and Importance: Persistent intraocular and intracorneal inflammation after cataract surgery should raise suspicion of endophthalmitis caused by fungi non-responsive to topical and intravitreal antibiotics. Surgical intervention and removal of the nidus of infection, which is often the intraocular lens and capsular bag, may be necessary for a successful outcome.
KW - Amphotericin B
KW - Clear corneal tunnel infection
KW - Fungal endophthalmitis
KW - Intravitreal antifungals
KW - Voriconazole
UR - http://www.scopus.com/inward/record.url?scp=85048945794&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048945794&partnerID=8YFLogxK
U2 - 10.1016/j.ajoc.2018.06.011
DO - 10.1016/j.ajoc.2018.06.011
M3 - Article
AN - SCOPUS:85048945794
VL - 11
SP - 109
EP - 114
JO - American Journal of Ophthalmology Case Reports
JF - American Journal of Ophthalmology Case Reports
SN - 2451-9936
ER -