Chronic exogenous exophiala dermatitidis endophthalmitis.
OBJECTIVE
To describe a case of chronic exogenous Exophiala dermatitidis endophthalmitis.


METHODS
Retrospective chart review and case report.


RESULTS
A 60-year-old man with history of chronic herpes zoster keratitis complicated by secondary fungal keratitis treated with penetrating keratoplasty presented with a white cataract, chronic anterior uveitis, and counting fingers vision in the left eye. Combined cataract extraction and diagnostic vitrectomy revealed positive cultures and polymerase chain reaction-based testing for E. dermatitidis-the same organism responsible for the keratitis. The patient was treated with multiple oral, intravenous, and intravitreal antifungal agents. Ultimately, the corneal infection recurred and the patient elected to undergo enucleation. Filamentous fungi consistent with E. dermatitidis infection were identified in the cornea of the enucleation specimen.


CONCLUSIONS
Although rare, Exophiala species can cause exogenous endophthalmitis. Chronic endophthalmitis should be suspected in patients who develop persistent intraocular inflammation after infectious keratitis.
*Department of Ophthalmology, California Pacific Medical Center, San Francisco, California; †West Coast Retina Medical Group, San Francisco, California; ‡Department of Ophthalmology, Kaiser Permanente Medical Center, Santa Rosa, California; §Department of Vision Science, School of Optometry, University of California, Berkeley, California; and ¶Department of Ophthalmology, Stanford University School of Medicine, Stanford, California.
Michael F
MF
Clamp
J Michael
JM
Jumper
Christine W
CW
Ku
H Richard
HR
McDonald
Robert N
RN
Johnson
Arthur D
AD
Fu
Brandon J
BJ
Lujan
Emmett T
ET
Cunningham
D002908:Chronic Disease; D009877:Endophthalmitis / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000382:microbiology*; D006801:Humans; D007634:Keratitis / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D060446:Phaeohyphomycosis / Q000175:diagnosis*; D012189:Retrospective Studies