Successful salvage therapy of Fusarium endophthalmitis secondary to keratitis: an interventional case series

Abstract

Purpose

To describe a combination of treatment modalities used for the successful eradication of Fusarium endophthalmitis.

Design

Interventional case series.

Participants

Three consecutive patients with keratitis-associated Fusarium endophthalmitis.

Methods

After failure of traditional management options, a combination of intravitreal and long-term, high-dose systemic voriconazole, topical antifungal medications, and surgical intervention, with penetrating keratoplasty, lensectomy, and endoscopic-guided pars plana vitrectomy, was administered to each patient.

Results

All three cases achieved full resolution of the infection, with a final Snellen visual acuity score of 20/50 to 20/70.

Conclusions

An aggressive combination of therapeutic modalities, including the removal of subiris abscesses, might be needed for the successful resolution of Fusarium endophthalmitis.

Keywords:

• endophthalmitis
• fungal
• fusarium
• keratitis
• keratoplasty
• voriconazole

Acknowledgments

This work was supported by a Postdoctoral Clinical/Translational Science Fellowship Award from the American Diabetes Association-Merck.

Portions of this manuscript were presented as a poster at the American Academy of Ophthalmology Annual Meeting, November, 2006, Las Vegas, NV.

Disclosure

The authors have no financial interest in any of the products discussed in this paper.