Endogenous Fusarium endophthalmitis in a patient with acute lymphocytic leukemia.
Endogenous fungal endophalmitis is an uncommon complication of systemic mycosis. Only a few cases involving Fusarium have been reported, most with unfavorable visual outcomes. We examined a 31-year-old woman with acute lymphocytic leukemia who developed sudden visual loss in her right eye. A dense, white placoid infiltrate was present in the right macula extending into the vitreous. An iris nodule and hypopyon were present in the left eye. A vitreous aspirate of the right eye was positive for Fusarium species. The patient progressively lost vision despite amphotericin B and 5-fluorocytosine therapy. She died from bronchopneumonia, fungemia, and multisystem failure. Histopathologic study disclosed a panophthalmitis with Fusarium organisms invading all the ocular coats in the right eye. Leukemic infiltrates were present in the left iris, anterior chamber, and trabecular meshwork. The ocular destructiveness of Fusarium may be caused by marked mycotic vascular invasion and occlusion with consequent infarction and necrosis of ocular tissues.
Patel
A S
AS
Department of Ophthalmology, University of Maryland Hospital, Baltimore 21201.
Hemady
R K
RK
Rodrigues
M
M
Rajagopalan
S
S
Elman
M J
MJ
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D005260:Female; D005670:Fusarium / Q000302:isolation & purification* / Q000648:ultrastructure; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D014822:Vitreous Body / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents