Chronic endophthalmitis due to Pyrenocheta romeroi in an immunocompetent host--a case report from southern India.
OBJECTIVE
Endophthalmitis due to Pyrenochaeta romeroi has not been reported in literature (PubMed, Medline). We report an interesting case of P. romeroi causing chronic endophthalmitis in an immunocompetent lady.


METHODS
Retrospective interventional case report. A 25-year-old immunocompetent lady presented with pain and redness in the left eye of 1-month duration. Her best-corrected visual acuity was 6/6 and 6/18 in the right and the left eyes, respectively. Slit-lamp examination of the left eye showed a corneal stromal scar, fibrinlike material in the anterior chamber, few retrolental cells, and normal fundus examination.


RESULTS
Aqueous taps on two occasions were negative for bacteria and fungi on routine smear, culture, and nested polymerase chain reaction. As inflammation recurred despite intravitreal voriconazole and amikacin injections, a lensectomy with vitrectomy was done. During vitrectomy, dense flocculent material was seen in the pars plana with only scleral indentation. The flocculent material grew a rare filamentous fungus called P. romeroi. The left eye underwent retinal detachment surgery with silicone oil insertion for a giant retinal tear at 2 months of follow-up. At 6 months of follow-up, her vision in the left eye was stable at 6/24 (Snellen) with no ocular inflammation.


CONCLUSIONS
P. romeroi may need to be added in the list of rare fungi, which cause chronic endophthalmitis.
*Department of Intraocular Inflammation and Vitreoretinal Services, Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Center, Bangalore, India; †Department of Medical Mycology, Kasturba Medical College, Manipal, India; and ‡Department of Microbiology and Infection Control, Fortis Hospitals, Bangalore, India.
Kalpana
K
Babu
Praveen R
PR
Murthy
Peralam Y
PY
Prakash
Jyoti
J
Kattige
Sukanya
S
Rangaswamy
Vinay R
VR
Murthy
Krishna R
KR
Murthy
D000328:Adult; D002908:Chronic Disease; D055135:Coelomomyces / Q000302:isolation & purification*; D009877:Endophthalmitis / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000382:microbiology*; D005260:Female; D006801:Humans; D012189:Retrospective Studies