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Zhao CS, Wai K, Koo EB, Rahimy E, Mruthyunjaya P, Mahajan VB, DeBoer CMT. Endogenous Fusarium Endophthalmitis after Bone Marrow Transplant: A Case Report and Literature Review. Vision (Basel) 2024; 8:44. [PMID: 39051230 PMCID: PMC11270371 DOI: 10.3390/vision8030044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 07/08/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
PURPOSE We aim to present a case of disseminated fusariosis that occurred in the setting of immunosuppression and presented with bilateral endogenous endophthalmitis, along with a literature review of Fusarium endophthalmitis, highlighting management strategies. OBSERVATION A 70-year-old male with acute myeloid leukemia who had recently undergone a bone marrow transplant noted bilateral floaters and decreased vision. He was found to have bilateral Fusarium endophthalmitis, with subsequent evidence of fungemia and fusariosis in his skin and joints. Despite aggressive local and systemic treatment, he succumbed to the disease. Endophthalmitis was initially stabilized with pars plana vitrectomy and intravitreal amphotericin and voriconazole until the patient transitioned to comfort measures. A review of 31 cases demonstrates that outcomes are poor and that the disease must be treated aggressively, often both systemically and surgically. CONCLUSION This case highlights the recalcitrance of Fusarium bacteremia and Fusarium endophthalmitis.
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Affiliation(s)
- Cindy S. Zhao
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
| | - Karen Wai
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
| | - Eubee B. Koo
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
| | - Ehsan Rahimy
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
- Department of Ophthalmology, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA
| | - Prithvi Mruthyunjaya
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
| | - Vinit B. Mahajan
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
- Molecular Surgery Laboratory, Stanford University, Palo Alto, CA 94303, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Charles M. T. DeBoer
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
- Molecular Surgery Laboratory, Stanford University, Palo Alto, CA 94303, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
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Patel TP, Zacks DN, Dedania VS. Antimicrobial guide to posterior segment infections. Graefes Arch Clin Exp Ophthalmol 2020; 259:2473-2501. [PMID: 33156370 DOI: 10.1007/s00417-020-04974-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/08/2020] [Accepted: 10/07/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE This review article is meant to serve as a reference guide and to assist the treating physician in making an appropriate selection and duration of an antimicrobial agent. METHODS Literature review. RESULTS Infections of the posterior segment require prompt medical or surgical therapy to reduce the risk of permanent vision loss. While numerous options exist to treat these infections, doses and alternative therapies, especially with contraindications for first-line therapy, are often elusive. Antimicrobial agents to treat posterior segment infections can be administered via various routes, including topical, intravitreal, intravenous, and oral. CONCLUSIONS Although there are many excellent review articles on the management of endophthalmitis, we take the opportunity in this review to comprehensively summarize the appropriate antimicrobial regimen of both common and rare infectious etiologies of the posterior segment, using evidence from clinical trials and large case series.
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Affiliation(s)
- Tapan P Patel
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University Hospital, Baltimore, MD, USA
| | - David N Zacks
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Vaidehi S Dedania
- Department of Ophthalmology, New York University School of Medicine, New York, NY, USA.
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Rizzello I, Castagnetti F, Toschi PG, Bertaccini P, Primavera L, Paolucci M, Faccioli L, Spinardi L, Lewis RE, Cavo M, Stanzani M. Successful treatment of bilateral endogenous Fusarium solani endophthalmitis in a patient with acute lymphocytic leukaemia. Mycoses 2017; 61:53-60. [PMID: 28872724 DOI: 10.1111/myc.12697] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/16/2017] [Accepted: 08/22/2017] [Indexed: 12/01/2022]
Abstract
Fusarium spp. are an uncommon cause of fungaemia in immunocompromised and neutropenic patients that may hematogenously disseminate to the eyes. Herein, we describe a patient with acute lymphoblastic leukaemia and a prior history of extensive corticosteroid exposure who developed disseminated Fusarium solani infection following chemotherapy despite posaconazole prophylaxis. She was successfully treated with combination liposomal amphotericin B and voriconazole, intraocular injections of voriconazole, topical amphotericin B and bilateral vitrectomy. We also review published literature describing the management of endogenous Fusarium endophthalmitis in immunocompromised hosts.
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Affiliation(s)
- Ilaria Rizzello
- Institute of Hematology "Lorenzo e Ariosto Seràgnoli", Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Hospital Teaching Hospital, University of Bologna, Bologna, Italy
| | - Fausto Castagnetti
- Institute of Hematology "Lorenzo e Ariosto Seràgnoli", Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Hospital Teaching Hospital, University of Bologna, Bologna, Italy
| | - Pier Giorgio Toschi
- Ophthalmology Unit, Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Patrizia Bertaccini
- Ophthalmology Unit, Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Laura Primavera
- Ophthalmology Unit, Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Michela Paolucci
- Unit of Clinical Microbiology, Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Luca Faccioli
- Diagnostic and Interventional Neuroradiology, Department of Head, Neck and Sense Organs, Sant'Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Luca Spinardi
- Diagnostic and Interventional Neuroradiology, Department of Head, Neck and Sense Organs, Sant'Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Russell E Lewis
- Department of Medical and Surgical Sciences (DIMEC), Clinic of Infectious Diseases, Sant'Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy
| | - Michele Cavo
- Institute of Hematology "Lorenzo e Ariosto Seràgnoli", Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Hospital Teaching Hospital, University of Bologna, Bologna, Italy
| | - Marta Stanzani
- Institute of Hematology "Lorenzo e Ariosto Seràgnoli", Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Hospital Teaching Hospital, University of Bologna, Bologna, Italy
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Ocampo-Garza J, Herz-Ruelas M, Chavez-Alvarez S, Gómez-Flores M, Vera-Cabrera L, Welsh-Lozano O, Gallardo-Rocha A, Escalante-Fuentes W, Ocampo-Candiani J. Disseminated fusariosis with endophthalmitis after skin trauma in acute lymphoblastic leukaemia. J Eur Acad Dermatol Venereol 2015; 30:e121-e123. [DOI: 10.1111/jdv.13392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J. Ocampo-Garza
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
| | - M.E. Herz-Ruelas
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
| | - S. Chavez-Alvarez
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
| | - M. Gómez-Flores
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
| | - L. Vera-Cabrera
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
| | - O. Welsh-Lozano
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
| | - A. Gallardo-Rocha
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
| | - W.G. Escalante-Fuentes
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
| | - J. Ocampo-Candiani
- Dermatology Department; University Hospital “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Monterrey México
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