Bilateral Aspergillus endophthalmitis following cataract surgery: a diagnostic and therapeutic challenge-a case report.

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL

Journal of Medical Case Reports Pub Date : 2025-07-03 DOI:10.1186/s13256-025-05373-1

Mohammadkarim Johari, Mostafa Abuali, Seyed Ahmad Razavizadegan, Mehdi Moallem

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引用次数: 0

Abstract

Background: Here we describe a case of bilateral Aspergillus endophthalmitis occurring 4 months after bilateral cataract surgery, manifesting as a spectacular filamentary branching on the intraocular lens/capsular surface and difficulties in treatment.

Case presentation: A 66-year-old Iranian male patient with a known case of chronic lymphocytic leukemia, who had previously undergone bilateral cataract surgery during the same session 4 months before, presented with a bilateral decrease in vision and vitreous haziness. The cytopathology results from vitreous sampling were negative for dysplastic cells. Still, the polymerase chain reaction analysis showed a positive result for Aspergillus sp., and a unique, striking filamentary branching growth appeared on the intraocular lens/capsular surface in both eyes. Treatment was challenging, with multiple vitrectomies and systemic and intravitreal anti-fungal agent treatment.

Conclusion: Challenges in managing bilateral Aspergillus endophthalmitis after cataract surgery in immunocompromised patients, diagnosis difficulties, voriconazole resistance, and the importance of early intervention are highlighted.

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白内障手术后双侧眼内曲霉菌炎：诊断和治疗的挑战- 1例报告。

背景：我们报告一例双侧白内障手术后4个月发生的双侧眼内曲霉菌性炎，表现为人工晶状体/囊表面出现明显的丝状分支，治疗困难。病例介绍：一名66岁伊朗男性患者，已知患有慢性淋巴细胞白血病，4个月前接受过双侧白内障手术，表现为双侧视力下降和玻璃体模糊。玻璃体取样的细胞病理学结果为发育不良细胞阴性。尽管如此，聚合酶链反应分析仍显示Aspergillus sp.阳性，并且在两只眼睛的人工晶状体/荚膜表面出现了独特的，显著的丝状分支生长。治疗是具有挑战性的，多次玻璃体切除术和全身和玻璃体内抗真菌药物治疗。结论：免疫功能低下患者白内障术后双侧眼内曲霉菌炎的治疗挑战、诊断困难、伏立康唑耐药性以及早期干预的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Case Reports Medicine-Medicine (all)

CiteScore

1.50

自引率

0.00%

发文量

436

期刊介绍： JMCR is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: 1. Unreported or unusual side effects or adverse interactions involving medications 2. Unexpected or unusual presentations of a disease 3. New associations or variations in disease processes 4. Presentations, diagnoses and/or management of new and emerging diseases 5. An unexpected association between diseases or symptoms 6. An unexpected event in the course of observing or treating a patient 7. Findings that shed new light on the possible pathogenesis of a disease or an adverse effect