Delayed-onset, bleb-associated endophthalmitis caused by lecythophora mutabilis☆
Accepted 20 August 2003.
Abstract
Purpose
To report delayed-onset, bleb-associated endophthalmitis caused by Lecythophora mutabilis.
Design
Interventional case report.
Methods
Description of an otherwise healthy woman who developed delayed-onset fungal endophthalmitis associated with a preexisting filtering bleb.
Results
A 57-year-old woman who underwent trabeculectomy with Mitomycin C in her left eye 8 years earlier presented with a 10-day history of pain and decreased vision in her left eye. She underwent anterior chamber and vitreous taps and injection of intraocular antibiotics. Cultures grew the mold Lecythophora mutabilis. The patient underwent treatment with intraocular and systemic antifungal agents, three pars plana vitrectomies, partial iridectomy, and cryopexy to the bleb and angle structures. Four months after her last treatment, her left eye shows no residual infection, and vision corrects to 20/80.
Conclusion
Bleb-associated endophthalmitis caused by L. mutabilis is resistant to amphotericin B but responsive to intravitreal and systemic voriconazole together with pars plana vitrectomy, iridectomy, and cryopexy to the bleb and angle structures.
aBascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Florida, USA
Inquiries to Ingrid U. Scott, MD, MPH, Bascom Palmer Eye Institute, P.O. Box 016880, Miami, FL 33101, USA; fax: (305) 326- 6417
☆ Supported in part by Research to Prevent Blindness, Inc., New York, New York.
ABSTRACT