title: Prolonged Curvularia endophthalmitis due to organism sequestration.
abstract: OBJECTIVE
  Endophthalmitis caused by Curvularia is a rare condition seen after cataract surgery and trauma. The clinical course has not been described previously.
  
  
  OBJECTIVE
  To examine the clinical course of 6 postoperative and trauma-related cases of Curvularia endophthalmitis.
  
  
  METHODS
  Retrospective case series. We reviewed the archives of the microbiology laboratory of Bascom Palmer Eye Institute, a tertiary referral hospital, from January 1, 1980, through September 30, 2013, to identify cases of Curvularia endophthalmitis. Data collected included demographic information, the cause of endophthalmitis, presenting features, treatment course, the number of recurrences, the area of organism sequestration, and final visual outcome.
  
  
  METHODS
  Trauma and cataract surgery.
  
  
  METHODS
  Times from the inciting event to presentation of symptoms, diagnosis, and eradication; visual acuity; and identification of the area of sequestration.
  
  
  RESULTS
  We identified 6 patients with Curvularia endophthalmitis, including 5 who underwent cataract surgery and 1 after trauma. The diagnosis was established rapidly in the trauma case. In the postoperative cases, the time from the surgery to first symptoms ranged from 2 to 5 months; from the surgery to correct diagnosis, 7 to 24 months; and from the surgery to eradication, 8 to 27 months. Despite aggressive antifungal therapy, eradication of the infection could be achieved only by identification and removal of the nidus of sequestration. The median follow-up was 29.5 months.
  
  
  CONCLUSIONS
  In cases of endophthalmitis caused by Curvularia, the diagnosis and treatment are often delayed, especially in postoperative cases. The eradication of the organism requires identification and removal of the nidi of sequestration.
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Aleksandra V
authors.initials: AV
authors.lastname: Rachitskaya
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida2Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville.
authors.forename: Ashvini K
authors.initials: AK
authors.lastname: Reddy
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Darlene
authors.initials: D
authors.lastname: Miller
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Janet
authors.initials: J
authors.lastname: Davis
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: William
authors.initials: W
authors.lastname: Smiddy
authors.affiliation: Retina Macula Specialists of Miami, Miami, Florida.
authors.forename: Wilfredo
authors.initials: W
authors.lastname: Lara
authors.affiliation: Kaufman Eye Institute, Zephyrhills, Florida.
authors.forename: Selina
authors.initials: S
authors.lastname: Lin
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Sander
authors.initials: S
authors.lastname: Dubovy
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Albini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001203:Ascomycota / Q000302:isolation & purification*; D002387:Cataract Extraction; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005131:Eye Injuries / Q000382:microbiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D019654:Lens Implantation, Intraocular; D008297:Male; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D011183:Postoperative Complications / Q000382:microbiology; D012189:Retrospective Studies; D014822:Vitreous Body / Q000382:microbiology; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents