Delayed-onset, bleb-associated endophthalmitis caused by Lecythophora mutabilis.
OBJECTIVE
To report delayed-onset, bleb-associated endophthalmitis caused by Lecythophora mutabilis.


METHODS
Interventional case report.


METHODS
Description of an otherwise healthy woman who developed delayed-onset fungal endophthalmitis associated with a preexisting filtering bleb.


RESULTS
A 57-year-old woman who underwent trabeculectomy with Mitomycin C in her left eye 8 years earlier presented with a 10-day history of pain and decreased vision in her left eye. She underwent anterior chamber and vitreous taps and injection of intraocular antibiotics. Cultures grew the mold Lecythophora mutabilis. The patient underwent treatment with intraocular and systemic antifungal agents, three pars plana vitrectomies, partial iridectomy, and cryopexy to the bleb and angle structures. Four months after her last treatment, her left eye shows no residual infection, and vision corrects to 20/80.


CONCLUSIONS
Bleb-associated endophthalmitis caused by L. mutabilis is resistant to amphotericin B but responsive to intravitreal and systemic voriconazole together with pars plana vitrectomy, iridectomy, and cryopexy to the bleb and angle structures.
Scott
Ingrid U
IU
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Florida 33101, USA. iscott@bpei.med.miami.edu
Cruz-Villegas
Vanessa
V
Flynn
Harry W
HW
Miller
Darlene
D
D000935:Antifungal Agents / Q000627:therapeutic use; D001768:Blister / Q000382:microbiology*; D003131:Combined Modality Therapy; D017679:Cryotherapy; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D032801:Iridectomy; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009181:Mycoses / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D010676:Phialophora / Q000302:isolation & purification*; D012008:Recurrence; D012086:Reoperation; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D014130:Trabeculectomy; D014821:Vitrectomy
D000935:Antifungal Agents; D016685:Mitomycin