Aspergillus Endogenous Endophthalmitis as a Clue to Identifying a Delayed Lumbosacral Osteomyelitis

ABSTRACT

Purpose

To present a case of aspergillus-induced endogenous endophthalmitis evolving into delayed lumbosacral osteomyelitis, initially misdiagnosed as ankylosing spondylitis (AS) in an immunocompetent patient.

Method

Case Report.

Results

A 38-year-old woman, initially treated for pneumonia, experienced sudden loss of vision in her left eye, prompting a thorough examination that revealed a distinct chorioretinal infiltrate. Microbiological analysis of the patient’s vitreous samples detected Aspergillus fumigatus, leading to the diagnosis of endogenous endophthalmitis. Treatment involved vitrectomy, intravitreal injections, and intravenous amphotericin B. Two months later, she was referred for lower back pain, misdiagnosed as AS. Lumbosacral biopsy confirmed Aspergillus involvement once more, necessitating antifungal therapy.

Conclusion

This case highlights the atypical progression of Aspergillus-induced endogenous endophthalmitis to delayed lumbosacral osteomyelitis in an immunocompetent individual. It highlights the crucial role of a meticulous medical history examination and interdisciplinary collaboration in diagnosing and managing diseases, especially in cases with atypical presentations.

KEYWORDS:

• Aspergillus fumigatus
• endogenous endophthalmitis
• immunocompetent
• osteomyelitis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Yeliz Delibay] and [Mustafa Erdogan]. The drafting and supervision of the manuscript was performed by [Muhammed Altinisik] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Statement of ethics

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Any reference to the patient in this case report has been removed and the images are anonymous. Ethical approval is not required for this study in accordance with local and national guidelines.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.