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Excellent outcome of Aspergillous endophthalmitis in a case of allergic bronchopulmonary aspergillosis.

Khan B, Vohra R, Kaur R, Singh S, AshapritpalVarti - Indian J Ophthalmol (2014)

Bottom Line: While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infections have been reported in immunocompetent individuals.He was treated with pars plana vitrectomy and intravitreal voriconazole and systemic itraconazole.The patient regained a vision of 20/30 with follow up of 2 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gian Sagar Medical College and Hospital, Banur, Patiala, Punjab, India.

ABSTRACT
While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infections have been reported in immunocompetent individuals. The purpose is to report an eye with post-operative Aspergillus endophthalmitis, which achieved a good visual outcome following early and aggressive treatment. A young patient, known case of allergic bronchopulmonary aspergillosis presented to us with post-cataract surgery endophthalmitis. He was treated with pars plana vitrectomy and intravitreal voriconazole and systemic itraconazole. The patient regained a vision of 20/30 with follow up of 2 years.

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Posterior segment photo of the patient 2 year postoperatively
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Figure 3: Posterior segment photo of the patient 2 year postoperatively

Mentions: He was put on topical voriconazole (10 mg/ml) drops one-hourly, and oral Itraconazole 200 mg twice-a-day was given for 6 wks. Oral prednisolone 1 mg/kg/bodyweight and topical prednisolone 1% were started in tapering doses. Two weeks post-vitrectomy BCVA in left eye was 20/50, anterior segment showed no activity [Fig. 2]. Retina was attached. One-month postoperative visual acuity improved to 20/30 in left eye. Fundus examination showed posterior vitreous detachment and a horseshoe tear in superonasal quadrant. Barrage laser was done for the same. After 1 month, his vision dropped to 20/70 and fundus showed a partial rhegmatogenous retinal detachment. He underwent revitrectomy with Belt Buckle with 360 degree Endolaser with silicone oil insertion. One-week post-operative showed attached retina [Fig. 3]. Two months post-surgery vision improved to 20/30. He was followed every month for 1 year, during which no complications developed. After Silicone oil removal, his BCVA is 20/30.


Excellent outcome of Aspergillous endophthalmitis in a case of allergic bronchopulmonary aspergillosis.

Khan B, Vohra R, Kaur R, Singh S, AshapritpalVarti - Indian J Ophthalmol (2014)

Posterior segment photo of the patient 2 year postoperatively
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061681&req=5

Figure 3: Posterior segment photo of the patient 2 year postoperatively
Mentions: He was put on topical voriconazole (10 mg/ml) drops one-hourly, and oral Itraconazole 200 mg twice-a-day was given for 6 wks. Oral prednisolone 1 mg/kg/bodyweight and topical prednisolone 1% were started in tapering doses. Two weeks post-vitrectomy BCVA in left eye was 20/50, anterior segment showed no activity [Fig. 2]. Retina was attached. One-month postoperative visual acuity improved to 20/30 in left eye. Fundus examination showed posterior vitreous detachment and a horseshoe tear in superonasal quadrant. Barrage laser was done for the same. After 1 month, his vision dropped to 20/70 and fundus showed a partial rhegmatogenous retinal detachment. He underwent revitrectomy with Belt Buckle with 360 degree Endolaser with silicone oil insertion. One-week post-operative showed attached retina [Fig. 3]. Two months post-surgery vision improved to 20/30. He was followed every month for 1 year, during which no complications developed. After Silicone oil removal, his BCVA is 20/30.

Bottom Line: While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infections have been reported in immunocompetent individuals.He was treated with pars plana vitrectomy and intravitreal voriconazole and systemic itraconazole.The patient regained a vision of 20/30 with follow up of 2 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gian Sagar Medical College and Hospital, Banur, Patiala, Punjab, India.

ABSTRACT
While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infections have been reported in immunocompetent individuals. The purpose is to report an eye with post-operative Aspergillus endophthalmitis, which achieved a good visual outcome following early and aggressive treatment. A young patient, known case of allergic bronchopulmonary aspergillosis presented to us with post-cataract surgery endophthalmitis. He was treated with pars plana vitrectomy and intravitreal voriconazole and systemic itraconazole. The patient regained a vision of 20/30 with follow up of 2 years.

Show MeSH
Related in: MedlinePlus