Bilateral endogenous Scedosporium prolificans endophthalmitis after lung transplantation.
OBJECTIVE
To report a case of bilateral endogenous fungal endophthalmitis resulting from disseminated Scedosporium prolificans.


METHODS
Observational case report.


METHODS
A 56-year-old woman with cystic fibrosis status post dual lung transplantation on chronic immunosuppressive therapy presented with acute graft rejection. Cultures of bronchial brushings revealed S. prolificans. Three weeks after admission, the patient noted increased blurriness and a central scotoma in her right eye. Dilated fundus examination revealed profound vitritis in the right eye with hemorrhagic retinitis involving the macula. A peripheral, yellow choroidal infiltrate with overlying retinitis and localized vitritis was present in the left eye.


RESULTS
Intravitreal antibiotics were initiated, and vitreous cultures revealed S. prolificans. The patient ultimately succumbed to her disseminated disease. Pathologic examination of the eyes confirmed bilateral endogenous fungal endophthalmitis.


CONCLUSIONS
S. prolificans is an opportunistic infection resistant to standard antifungal therapy that can result in endogenous endophthalmitis in immunocompromised individuals.
Vagefi
M Reza
MR
Department of Ophthalmology, University of California, San Francisco, California 94143-0730, USA.
Kim
Eleanore T
ET
Alvarado
Richard G
RG
Duncan
Jacque L
JL
Howes
Ed L
EL
Crawford
J Brooks
JB
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002825:Chorioretinitis / Q000382:microbiology; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016040:Lung Transplantation; D008875:Middle Aged; D008271:Mycetoma / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D021681:Scedosporium / Q000302:isolation & purification*; D014822:Vitreous Body / Q000382:microbiology
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents