title: Aspergillus flavus endophthalmitis after penetrating keratoplasty combined with cataract phacoemulsification and IOL implantation.
abstract: To report the clinical findings and management of a case of Aspergillus flavus endophthalmitis following penetrating keratoplasty (PKP) and combined cataract extraction. Clinical cornea appearance was evaluated by slit-lamp examination. Ocular ultrasonography was performed to evaluate the anterior chamber and vitreous cavity. The cornea was scraped. The corneal-scleral donor rim and media were cultured. The diagnosis of A. flavus infection was made. The patient received fortified antifungal drops (voriconazole 1 % solution) plus systemic voriconazole 400 mg/die. A second corneal transplant was performed, and the anterior chamber was cleaned and washed with a solution of voriconazole 1 %. At the end of follow-up, CDVA was 20/20 and slit-lamp examination showed a clear cornea graft. This case illustrates a severe A. flavus endophthalmitis after PKP and demonstrates the possibilities of visual function restoration. Furthermore, this case describes the different sources of fungal infection after PKP and the different clinical appearances.
authors.affiliation: Department of Medical-Surgical Sciences and Biotechnology, "Sapienza" University of Rome, Latina, Italy. leopoldo.spadea@uniroma1.it.|, Via Benozzo Gozzoli 34, 00142, Rome, Italy. leopoldo.spadea@uniroma1.it.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Spadea
authors.affiliation: Department of Ophthalmology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Abbouda
authors.affiliation: Department of Ophthalmology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Abicca
authors.affiliation: Department of Ophthalmology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Paroli
mesh_terms: D001231:Aspergillus flavus / Q000302:isolation & purification*; D002386:Cataract / Q000150:complications*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000009:adverse effects*; D009877:Endophthalmitis / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D013530:Surgical Wound Infection; D014792:Visual Acuity
keywords: Aspergillus flavus; Cataract phacoemulsification; Endophthalmitis; Penetrating keratoplasty