Post-operative endophthalmitis caused by Acremonium falciforme with orbital and extra-orbital involvement following combined cataract and glaucoma surgery: a case report

Journal of Medical Case Reports

Leopoldo Spadea²  Marco Lupidi¹  Tito Fiore¹  Alessia Iannone¹  Carlo Cagini¹ 

[1] Department of Surgical and Biomedical Sciences, University of Perugia, Ospedale S Maria della Misericordia, Sant’Andrea delle Fratte, Piazza Menghini 1, 06156 Perugia, Italy;Department of Biotechnology and Medical-Surgical Sciences, University of Rome “La Sapienza”, Via Benozzo Gozzoli 34, 00142 Roma, Italy

关键词: Orbital involvement;    Fungal endophthalmitis;    Cataract surgery;   

Others  :  1180980
DOI  :  10.1186/1752-1947-8-373

 received in 2014-04-08, accepted in 2014-08-28,  发布年份 2014

【 摘 要 】

Introduction

In this report, we describe an unusual case of post-operative Acremonium falciforme endophthalmitis with orbital and extra-orbital involvement following combined cataract and glaucoma surgery.

Case presentation

A 68-year-old Caucasian man with glaucoma presented with endophthalmitis characterized by pain, redness and impaired vision in the left eye fifteen days after combined cataract and filtering surgery. He subsequently underwent a pars plana vitrectomy, with vitreous sampling, silicone oil placement and intra-vitreal injection of antibiotics, but only after a second vitrectomy we identified Acremonium falciforme as the causative agent for the endophthalmitis. An antifungal systemic and topical therapy was started, but meanwhile the infection extended to orbital and peri-orbital tissues. Following these procedures, even if the eye went slowly in phthisis, we were able to limit the further extension and circumscribe the orbital and extra-orbital involvement.

Conclusion

To our knowledge, this report is the first describe Acremonium falciforme endophthalmitis with orbital and extra-orbital involvement, following anterior segment combined surgery. Ophthalmologists and physicians should be aware of the extension risk of a fungal panophthalmitis, but also to potentially serious side effects related to systemic therapy.

【 授权许可】

   
2014 Cagini et al.; licensee BioMed Central Ltd.

【 图 表 】

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