Control of disseminated scedosporium prolificans infection and endophthalmitis.
OBJECTIVE
To report a case of endogenous endophthalmitis as the presenting sign of a disseminated Scedosporium prolificans infection.


METHODS
A 38-year-old woman on chronic immunosuppressive treatment for a cardiac transplant was examined for blurry vision in her right eye. Dilated fundus examination in the right eye revealed a large serous retinal detachment with subretinal cream-colored masses.


RESULTS
Complete pars plana vitrectomy with vitreal biopsies was performed and revealed S. prolificans on culture. Multiple intravitreal voriconazole injections as well as systemic voriconazole and terbinafine resulted in control and suppression of both the ocular and systemic disease.


CONCLUSIONS
Scedosporium prolificans endogenous endophthalmitis represents a difficult to treat opportunistic infection in immunocompromised patients. However, newer-generation antifungals offer the potential for suppression of systemic disease and the possibility of avoiding enucleation in the setting of endophthalmitis.
From the *Doheny Eye Institute; and †Department of Medicine, Division of Infectious Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California.
Thomas M
TM
OʼHearn
P Jan
PJ
Geiseler
Rizwan A
RA
Bhatti
Dean
D
Eliott