title: Isolated endogenous endophthalmitis due to a sporodochial-forming Phialemonium curvatum acquired through intracavernous autoinjections.
abstract: We report a case of endogenous endophthalmitis due to a sporodochial-forming species of Phialemonium curvatum. The infection led to the enucleation of the affected eye, but there was no evidence of systemic dissemination. The isolated P. curvatum produced aggregates of phialides, many occurring on coils or in verticils, which eventually develop into sporodochia. The initial and post-enucleation isolates revealed they were identical to strains of P. curvatum from Israel causing disseminated disease in patients practicing intracavernous autoinjections for the treatment of erectile dysfunction. The reported case had unusual clinical and microbiological features. Despite the route of acquisition and the lack of systemic antifungal therapy, the infection did not spread beyond the eye. The morphology of the phialides aggregates was also unique, and the distinction between Volutella and Acremonium is discussed. This case expands the spectrum of infections due to Phialemonium species, and reveals a novel way of developing fungal endophthalmitis.
authors.affiliation: Internal Medicine C & Infectious Diseases, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel. miriw@netvision.net.il
authors.forename: M
authors.initials: M
authors.lastname: Weinberger
authors.forename: I
authors.initials: I
authors.lastname: Mahrshak
authors.forename: N
authors.initials: N
authors.lastname: Keller
authors.forename: A
authors.initials: A
authors.lastname: Goldscmied-Reuven
authors.forename: N
authors.initials: N
authors.lastname: Amariglio
authors.forename: M
authors.initials: M
authors.lastname: Kramer
authors.forename: A
authors.initials: A
authors.lastname: Tobar
authors.forename: Z
authors.initials: Z
authors.lastname: Samra
authors.forename: S D
authors.initials: SD
authors.lastname: Pitlik
authors.forename: M G
authors.initials: MG
authors.lastname: Rinaldi
authors.forename: E
authors.initials: E
authors.lastname: Thompson
authors.forename: D
authors.initials: D
authors.lastname: Sutton
mesh_terms: D000368:Aged; D001203:Ascomycota / Q000187:drug effects / Q000302:isolation & purification*; D009877:Endophthalmitis / Q000209:etiology*; D007172:Erectile Dysfunction / Q000188:drug therapy; D015821:Eye Infections, Fungal / Q000209:etiology*; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008297:Male; D010413:Penis / Q000187:drug effects; D012646:Self Administration