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Case Reports in Ophthalmological Medicine
Volume 2016 (2016), Article ID 4593042, 4 pages
http://dx.doi.org/10.1155/2016/4593042
Case Report

Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole

1Department of Ophthalmology, Clínica Santa María, Avenida Santa María 500, Providencia, 7520378 Santiago, Chile
2Department of Cornea and Refractive Surgery, Centro Laser, C/Fantino Falco 3, Naco, 10122 Santo Domingo, Dominican Republic

Received 22 April 2016; Accepted 29 May 2016

Academic Editor: Stephen G. Schwartz

Copyright © 2016 Paulo A. Alves da Costa Pertuiset and Juan F. Batlle Logroño. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To report a case of postoperative endophthalmitis caused by Fusarium species successfully treated with intravitreal and systemic voriconazole after treatment failure with amphotericin B. Methods. Clinical case report of a 60-year-old immunocompetent woman who presents with endophthalmitis of unknown origin 4 weeks after uneventful cataract extraction and IOL implantation surgery. IOL explantation, vitrectomy with capsular bag removal, vitreous aspiration for culture, and intravitreal injection of amphotericin B (5 μg/0.1 mL) were performed. Diagnosis was established by culturing the vitreous aspirate on a Sabouraud agar medium and staining with lactophenol blue solution. Five days later, there was no clinical response. The decision was made to administer a single dose of intravitreal voriconazole (2.5 μg/0.1 mL) and oral voriconazole (200 mg BID) for 30 days. Results. Fusarium sp. grew on culture. Treatment with local and systemic voriconazole was started after no improvement with vitrectomy, IOL explantation, and intravitreal amphotericin B. After 1 month of treatment, the infection resolved and best-corrected visual acuity was 20/25. Conclusion. In patients with endophthalmitis caused by Fusarium sp., topical and systemic voriconazole treatment should be considered in cases resistant to intravitreal amphotericin B.