Wickerhamomyces Anomalus Postoperative Endophthalmitis

ABSTRACT

Introduction

We describe the case of a postoperative fungal endophthalmitis caused by Wickerhamomyces anomalus, an opportunistic yeast common in nature but rare as a causative agent in ocular infections. This would be the second reported case of W. anomalus endophthalmitis.

Case report

A patient came to our hospital with a dense hemovitreous caused by an inadvertent ocular perforation and retinal detachment during a cataract surgery. In the days following the first vitreoretinal surgery a chronic postoperative endophthalmitis was evidenced. Only after several surgeries as well as intravitreal antibiotics and sample takings, Wickerhamomyces was detected. The treatment with oral voriconazole and an intraocular lens extraction controlled the infection.

Discussion

Wickerhamomyces anomalus, despite not being particularly aggressive in our case, was resistant to various consequent vitreoretinal surgeries. The unresponsiveness to treatment led us to contemplate the fungal etiology, and fortunately the cultures were positive for this yeast. In conjunction to antifungal therapy, it is possible that the IOL explantation played an important role in the treatment.

Conclusion

A high index of suspicion must be held in cases of fungal endophthalmitis. Both IOL explantation and oral antifungal therapy are useful treatment options in cases of W. anomalus endophthalmitis.

KEYWORDS:

• Endophthalmitis
• fungal endophthalmitis
• ocular perforation
• Pichia anomala
• uveitis
• Wickerhamomyces anomalus

Acknowledgments

To Dr. Ruiz Pérez de Pipaón, MD, member of the Microbiology Unit in Hospital Virgen del Rocío for her counseling.

Disclosure statement

No potential conflict of interest was reported by the authors.

Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

Authorship

All of the authors have contributed to write the study, meet the requirements of authorship and have approved the final version. On their behalf, I hereby declare that the work is original and has neither been published nor is in any review process elsewhere and we have no conflicts of interest to disclose at this point.

Additional information

Funding

The authors reported there is no funding associated with the work featured in this article.