ABSTRACT

Purpose

To study the clinical profile and management of a case of fungal postoperative endophthalmitis caused by fusarium solani.

Case report

A 40-year-old male underwent an uneventful cataract surgery developed postoperative endophthalmitis. The infection was fulminant and was treated aggressively with pars plana vitrectomy with intravitreal and oral antifungals. The microbiology culture of vitreous sample showed fusarium solani. There was a late recurrence in the form of a fungal ball behind the iris after 6 months of the initial episode. This fungal ball was then managed by transscleral cryotherapy. The eye became hypotonus due to chronic inflammation and silicone oil was instilled to salvage the eye.

Conclusion

Fusarium endophthalmitis needs an aggressive management. Due to late recurrence regular follow-up is mandatory. Early vitrectomy with oral and intravitreal voriconazole is the treatment of choice. Transscleral cryotherapy is a useful option to treat fungal balls behind the iris tissue.

中文翻译：

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镰刀菌致顽固性术后眼内炎一例文献复习报告

摘要

目的

研究一例由茄病镰刀菌引起的真菌性术后眼内炎的临床特征和处理。

案例报告

一名 40 岁男性在接受白内障手术时顺利进行了术后眼内炎。感染是暴发性的，并通过玻璃体腔内和口服抗真菌剂的睫状体玻璃体切除术积极治疗。玻璃体样品微生物培养显示茄病镰刀菌。首次发作 6 个月后，虹膜后出现真菌球形式的晚期复发。然后通过经巩膜冷冻疗法管理这个真菌球。由于慢性炎症，眼睛变得低张力，并滴注硅油以挽救眼睛。

结论

镰刀菌眼内炎需要积极的管理。由于晚期复发，定期随访是强制性的。口服和玻璃体内伏立康唑的早期玻璃体切除术是首选治疗方法。经巩膜冷冻疗法是治疗虹膜组织后面的真菌球的有用选择。