Excellent visual outcome following Aspergillus flavus endogenous endophthalmitis-farmer's lung disease.
BACKGROUND
The purpose is to report an eye with endogenous Aspergillus flavus endophthalmitis that achieved a good visual outcome following early and aggressive management.


METHODS
A 76-year-old male recently hospitalized for allergic Aspergillus pneumonitis after cleaning out a grain bin presented with reduced vision and anterior chamber and vitreous inflammation. The patient was treated with intravenous amphotericin and a pars plana vitrectomy with intravitreal amphotericin, and the vitreous biopsy sent for histopathological and microbial analysis.


RESULTS
A. flavus was isolated from the vitreous biopsy. Two weeks after vitrectomy, intravitreal amphotericin was again injected into the affected eye. The patient regained vision to 20/80 several months later, despite a moderate cataract.


CONCLUSIONS
Early treatment of A. flavus endophthalmitis with pars plana vitrectomy, intravitreal and systemic amphotericin can lead to good visual outcomes.
Bakri
Sophie J
SJ
Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA. sbakri@hotmail.com
Sears
Jonathan E
JE
Procop
Gary W
GW
Shrestha
Rabin
R
Gordon
Steven M
SM
D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage; D000867:Anterior Chamber / Q000382:microbiology / Q000473:pathology; D000935:Antifungal Agents / Q000008:administration & dosage; D001228:Aspergillosis / Q000150:complications* / Q000382:microbiology; D001231:Aspergillus flavus / Q000302:isolation & purification*; D009877:Endophthalmitis / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D005203:Farmer's Lung / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007249:Inflammation; D056965:Injections, Intraocular; D007275:Injections, Intravenous; D008297:Male; D016896:Treatment Outcome; D015354:Vision, Low / Q000209:etiology; D014785:Vision, Ocular; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000382:microbiology / Q000473:pathology / Q000601:surgery
D000935:Antifungal Agents; D000666:Amphotericin B