The first case of fungal endophthalmitis caused by Emericella nidulans after cataract surgery.
Emericella nidulans is a species that has only rarely been implicated in human disease after cataract surgery. Here, we report the first postoperative case in the literature, as far as we know. The patient was a 50-year-old patient presented with mild anterior uveitis one week after cataract surgery, and hypopion developed over the next two days. First microbiological evaluation and the results of direct microscopy and cultures of the anterior chamber and vitreous samples were found to be negative. Despite vigorous topical and intravitreal (vancomycin and amikacin) therapy, the endophthalmitis did not improve. Anterior chamber paracentesis, vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens (IOL) were performed. The anterior chamber, vitreous fluid samples and IOL were submitted to the microbiology laboratory: the culture yielded E. nidulans growth. Ocular inflammation resolved and vision improved on intravenous, subconjunctival and long-term oral voriconazole treatment. E. nidulans can be an important cause of ocular fungal infections including endophthalmitis, and voriconazole seems to be effective for the treatment of E. nidulans endophthalmitis.
Departments of Ophthalmology, Ankara, Turkey.
F M
FM
Mutlu
Medical Microbiology of Gülhane Military Medical Academy & Medical School, Ankara, Turkey.
S T
ST
Yildiran
Medical Microbiology of Gülhane Military Medical Academy & Medical School, Ankara, Turkey. Electronic address: saraclima@yahoo.com.
M A
MA
Saracli
Medical Microbiology of Gülhane Military Medical Academy & Medical School, Ankara, Turkey.
R
R
Gümral
Departments of Ophthalmology, Ankara, Turkey.
H
H
Durukan
Departments of Ophthalmology, Ankara, Turkey.
G
G
Sobaci
Clinical Microbiology and Infectious Disease Clinic, Ankara Training and Research Hospital, Ankara, Turkey.
A G
AG
Mutlu
D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D001233:Aspergillus nidulans / Q000302:isolation & purification; D002387:Cataract Extraction / Q000009:adverse effects*; D032842:Emericella / Q000254:growth & development / Q000302:isolation & purification*; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology*; D065819:Voriconazole / Q000627:therapeutic use
D000935:Antifungal Agents; D065819:Voriconazole
Cataract; Cataracte; Emericella nidulans; Endophtalmie; Endophthalmitis; Fungus; Mycose; Phacoemulsification; Phacoémulsification; Postoperative; Postopératoire; Voriconazole