Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2024, Vol. 38 ›› Issue (2): 103-108.doi: 10.6040/j.issn.1673-3770.0.2023.024

• Original Article • Previous Articles     Next Articles

Fungal endophthalmitis in a patient with no history of vegetative trauma: a case report and literature review

LI Shuting, ZHAO Hui, SI Mingwei, CUI Wenxuan, YANG Mengyao, WANG Hong   

  1. Department of Ophthalmology, Qilu Hospital of Shandong University/The First Clinical College of Shandong University, Jinan 250012, Shandong, China
  • Online:2024-03-20 Published:2024-03-29

Abstract: Objective This report describes the pathogenesis in a patient with no history of vegetative trauma who was diagnosed with fungal endophthalmitis combined with diabetes mellitus. Methods A 53-year-old male patient with sharply decreased visual acuity in the left eye did not significantly improve after receiving glucocorticoid treatment for shock in an outside hospital. Fifteen d later, intraocular fluids analysis was performed in the Ophthalmology Department of Qilu Hospital of Shandong University to identify the causative organism. Moreover, ultrasonic emulsification for cataract, vitrectomy, intraocular laser, silicone oil filling, and intravitreal injection(voriconazole, 0.02 mg)were performed in the left eye. Results Postoperative vitreous fluid was submitted for staining: fungus(-). Corrected visual acuity: 0.1 in the right eye and HM/5 cm in the left eye and stable condition of the posterior anterior segment of the eye were found. Conclusion Fusarium is a rare but recognized cause of endogenous endophthalmitis in immunocompromised patients via various routes of infection. Diabetes mellitus and steroid hormone application could reduce the stability of the patient's immune system. Timely diagnosis and antifungal treatment were very important for improving the patient's prognosis.

Key words: Endogenous endophthalmitis, History of vegetative trauma, Diabetes mellitus, Fusarium, Glucocorticoids

CLC Number: 

  • R771.2
[1] Sowik M, Biernat MM, Urbaniak-Kujda D, et al. Mycotic infections of the eye[J]. Adv Clin Exp Med, 2015, 24(6): 1113-1117. doi:10.17219/acem/50572
[2] 张文华, 潘志强, 王智群, 等. 化脓性角膜溃疡常见致病菌的变迁[J]. 中华眼科杂志, 2002(1): 8-12. doi:10.3760/j: issn: 0412-4081.2002.01.004 ZHANG Wenhua, PAN Zhiqiang, WANG Zhiqun, et al. The variance of pathogenic organisms of purulent ulcerative keratitis[J]. Chinese Journal of Ophthalmology, 2002(1): 8-12. doi:10.3760/j: issn: 0412-4081.2002.01.004
[3] 王丽娅, 张月琴, 王印其, 等. 中国三地区真菌性角膜病致病菌种的调查[J]. 中华眼科杂志, 2000(2): 138-140. doi:10.3760/j: issn: 0412-4081.2000.02.017 WANG Liya, ZHANG Yueqin, WANG Yinqi, et al. Spectrum of mycotic keratitis in China[J]. Chinese Journal of Ophthalmology, 2000(2): 138-140. doi:10.3760/j: issn: 0412-4081.2000.02.017
[4] Xie LX, Shi WY, Liu ZS, et al. Lamellar keratoplasty for the treatment of fungal keratitis[J]. Cornea, 2002, 21(1): 33-37. doi:10.1097/00003226-200201000-00008
[5] Xie L, Dong X, Shi W. Treatment of fungal keratitis by penetrating keratoplasty[J]. Br J Ophthalmol, 2001, 85(9): 1070-1074. doi:10.1136/bjo.85.9.1070
[6] 孙士营,赵格,孙晓艳,等.真菌性眼内炎常见病因及致病菌种分析[J].中华眼科杂志, 2014, 50(11): 808-813. doi:10.3760/cma.j.issn.0412-4081.2014.11.003 SUN Shiying, ZHAO Ge, SUN Xiaoyan, et al. Analysis of common causes and pathogenic species of fungal endophthalmitis[J]. Chinese Journal of Ophthalmology, 2014, 50(11): 808-813. doi:10.3760/cma. J. issn. 0412-4081.2014.11.003
[7] Lingappan A, Wykoff CC, Albini TA, et al. Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes[J]. Am J Ophthalmol, 2012,153(1): 162-166. doi: 10.1016/j.ajo.2011.06.020
[8] 李曼,王艳玲,赵露.白内障术后粪肠球菌眼内炎1例并文献复习[J].山东大学耳鼻喉眼学报, 2022, 36(6): 56-59. doi:10.6040/j.issn.1673-3770.02021.187 LI Man, WANG Yanling, ZHAO Lu. A case of Enterococcus faecalis endophthalmitis after cataract surgery and review of the literature [J]. Journal of Otolaryngology and Ophthalmology, Shandong University, 2022, 36(6): 56-59. doi:10.6040/j.issn.1673-3770.02021.187
[9] Clarke B, Williamson TH, Gini G, et al. Management of bacterial postoperative endophthalmitis and the role of vitrectomy[J]. Surv Ophthalmol, 2018, 63(5): 677-693. doi:10.1016/j.survophthal.2018.02.003
[10] Relhan N, Forster RK, Flynn HW. Endophthalmitis: then and now[J]. Am J Ophthalmol, 2018, 187: xx-xxvii. doi:10.1016/j.ajo.2017.11.021
[11] Jackson TL, Paraskevopoulos T, Georgalas I. Systematic review of 342 cases of endogenous bacterial endophthalmitis[J]. Surv Ophthalmol, 2014, 59(6): 627-635. doi:10.1016/j.survophthal.2014.06.002
[12] Connell PP, O'Neill EC, Fabinyi D, et al. Endogenous endophthalmitis: 10-year experience at a tertiary referral centre[J]. Eye(Lond), 2011, 25(1): 66-72. doi:10.1038/eye.2010.145
[13] Connell PP, O'Neill EC, Amirul Islam FM, et al. Endogenous endophthalmitis associated with intravenous drug abuse: seven-year experience at a tertiary referral center[J]. Retina, 2010, 30(10): 1721-1725. doi:10.1097/IAE.0b013e3181dd6db6
[14] Vaziri K, Pershing S, Albini TA, et al. Risk factors predictive of endogenous endophthalmitis among hospitalized patients with hematogenous infections in the UnitedStates[J]. Am J Ophthalmol, 2015, 159(3): 498-504. doi:10.1016/j.ajo.2014.11.032
[15] Sridhar J, Flynn HW Jr, Kuriyan AE, et al. Endogenous fungal endophthalmitis: risk factors, clinical features, and treatment outcomes in mold and yeast infections[J]. J Ophthalmic Inflamm Infect, 2013, 3(1): 60. doi:10.1186/1869-5760-3-60
[16] Keyashian K, Malani PN. Endophthalmitis associated with intravenous drug use[J]. South Med J, 2007, 100(12): 1219-1220. doi:10.1097/SMJ.0b013e3181581191
[17] Patel SN, Rescigno RJ, Zarbin MA, et al. Endogenous endophthalmitis associated with intravenous drug abuse[J]. Retina, 2014, 34(7): 1460-1465. doi:10.1097/IAE.0000000000000084
[18] Shrader SK, Band JD, Lauter CB, et al. The clinical spectrum of endophthalmitis: incidence, predisposing factors, and features influencing outcome[J]. J Infect Dis, 1990, 162(1): 115-120. doi:10.1093/infdis/162.1.115
[19] Binder MI, Chua J, Kaiser PK, et al. Endogenous endophthalmitis: an 18-year review of culture-positive cases at a tertiary care center[J]. Medicine, 2003, 82(2): 97-105. doi:10.1097/00005792-200303000-00004
[20] Cho H, Shin YU, Siegel NH, et al. Endogenous endophthalmitis in the American and Korean population: an 8-year retrospective study[J]. Ocul Immunol Inflamm, 2018, 26(4): 496-503. doi:10.1080/09273948.2016.1195000
[21] Jørgensen JS, Prause JU, Kiilgaard JF. Bilateral endogenous Fusarium solani endophthalmitis in a liver-transplanted patient: a case report[J]. J Med Case Rep, 2014, 8: 101. doi: 10.1186/1752-1947-8-101
[22] Lieberman TW, Ferry AP, Bottone EJ. Fusarium solani endophthalmitis without primary corneal involvement[J]. Am J Ophthalmol, 1979, 88(4): 764-767. doi: 10.1016/0002-9394(79)90680-9
[23] Kumar KK, Sampritha UC, Prakash AA, et al. Ophthalmic manifestations in the COVID-19 clinical spectrum[J]. Indian J Ophthalmol, 2021, 69(3): 691-694. doi:10.4103/ijo.IJO_3037_20
[24] Sheth JU, Narayanan R, Goyal J, et al. Retinal vein occlusion in COVID-19: a novel entity[J]. Indian J Ophthalmol, 2020, 68(10): 2291-2293. doi:10.4103/ijo.IJO_2380_20
[25] Dumitrascu OM, Volod O, Bose S, et al. Acute ophthalmic artery occlusion in a COVID-19 patient on apixaban[J]. J Stroke Cerebrovasc Dis, 2020, 29(8): 104982. doi:10.1016/j.jstrokecerebrovasdis.2020.104982
[26] Virgo J, Mohamed M. Paracentral acute middle maculopathy and acute macular neuroretinopathy following SARS-CoV-2 infection[J]. Eye(Lond), 2020, 34(12): 2352-2353. doi:10.1038/s41433-020-1069-8
[27] Shroff D, Narula R, Atri N, et al. Endogenous fungal endophthalmitis following intensive corticosteroid therapy in severe COVID-19 disease[J]. Indian J Ophthalmol, 2021, 69(7): 1909-1914. doi:10.4103/ijo.IJO_592_21
[28] Yang L, Gou JJ, Gao JB, et al. Immune characteristics of severe and critical COVID-19 patients[J]. Signal Transduct Target Ther, 2020, 5(1): 179. doi:10.1038/s41392-020-00296-3
[29] Chalmers JD, Crichton ML, Goeminne PC, et al. Management of hospitalised adults with coronavirus disease 2019(COVID-19): a European Respiratory Society living guideline[J]. Eur Respir J, 2021, 15, 57(4): 2100048. doi: 10.1183/13993003.50048-2021
[30] Lim HW, Shin JW, Cho HY, et al. Endogenous endophthalmitis in the Korean population: a six-year retrospective study[J]. Retina, 2014, 34(3): 592-602. doi:10.1097/IAE.0b013e3182a2e705
[31] Wong JS, Chan TK, Lee HM, et al. Endogenous bacterial endophthalmitis: an East Asian experience and a reappraisal of a severe ocular affliction[J]. Ophthalmology, 2000, 107(8): 1483-1491. doi:10.1016/s0161-6420(00)00216-5
[32] Coburn PS, Wiskur BJ, Christy E, et al. The diabetic ocular environment facilitates the development of endogenous bacterial endophthalmitis[J]. Invest Ophthalmol Vis Sci, 2012, 53(12): 7426-7431. doi:10.1167/iovs.12-10661
[33] Chongkae S, Youngchim S, Nosanchuk JD, et al. Fungal keratitis in northern Thailand: spectrum of agents, risk factors and putative virulence factors[J]. J Fungi(Basel), 2021, 7(6): 475. doi:10.3390/jof7060475
[34] Sahay P, Goel S, Nagpal R, et al. Infectious keratitis caused by rare and emerging micro-organisms[J]. Curr Eye Res, 2020, 45(7): 761-773. doi:10.1080/02713683.2019.1708407
[35] Maitray A, Rishi E, Rishi P, et al. Endogenous endophthalmitis in children and adolescents: case series and literature review[J]. Indian J Ophthalmol, 2019, 67(6): 795-800. doi:10.4103/ijo.IJO_710_18
[36] 王文吉. 内源性真菌性眼内炎[J]. 中国眼耳鼻喉科杂志, 2018, 18(2): 82-84. doi:10.14166/j.issn.1671-2420.2018.02.003 WANG Wenji. Endogenous fungal endophthalmitis[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2018, 18(2): 82-84. doi:10.14166/j.issn.1671-2420.2018.02.003
[1] WANG Lixue, ZENG Yi, WANG Lixin, PENG Xianbing. Clinical observation of the effect of infiltrating Biprofen Gelatin Sponge after functional endoscopic sinus surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 16-25.
[2] LU Gan, DENG Yuqin, TAO Zezhang. Relationship between allergic diseases and diabetes mellitus and underlying mechanisms [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 215-222.
[3] WANG Xu, GAO Xin, ZHANG Yuguang. Clinical study of accelerated corneal collagen crosslinking in the treatment of fungal keratitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 51-57.
[4] ZHONG Liping, GUAN Xilong, WANG Jingjing, TANG Yong. Intratympanic injections and systemic glucocorticoid treatment for sudden hearing loss: a systematic review and Meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 1-10.
[5] PU Yadi, LI Yuanbin. Endogenous endophthalmitis associated with Klebsiella pneumoniae pyogenic liver abscess: a report of 31 cases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 95-98.
[6] LIU Jianbo, ZHANG Huan. Phacoemulsification combined with intravitreal ranibizumab or triamcinolone acetonide injection for the treatment of cataract accompanied by diabetic macular edema [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 99-104.
[7] LI Huabin, LAI Yuting. Pathogenesis, diagnosis, and treatment of chronic rhinosinusitis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 4-9.
[8] ZHANG Ying, CHEN Hongmei, WU Xinyi.. Delayed corneal wound healing is related to impaired IGF-1 expression in diabetic rats. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(6): 74-78.
[9] SHI Li, ZHAO Li, ZHANG Hongping. Long-term anti-inflammatory treatment of allergic rhinitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 9-12.
[10] SHAO Na, ZHANG Han. Variation of visual acuity and fundus in type 2 diabetic patients after phacoemulsification surgery. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(1): 83-87.
[11] WANG Luping, WU Xinyi. Effect of glycosylated hemoglobin on dry eye in patients with type 2 diabetes mellitus [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(6): 71-73.
[12] JIANG Luyun, XIE Hui, XIE Yan, LI Xinrong. Intratympanic budesonide suspension injection to treat idiopathic sudden deafness with type Ⅱ diabetes mellitus in 42 patients [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(3): 20-23.
[13] SUN Hong-yi, ZHANG Han. Changes of macular thickness under optical coherent tomography in type 2 diabetic patients with cataract after phacoemulsification surgery and IOL implantation [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(6): 72-76.
[14] WANG Zheng-yan . Effect of phacoemulsification combined with intraocular lens implantation in diabetic patients with cataract [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(1): 78-80 .
[15] ZHU Huabin,FENG Yunhai,YIN Shankai,ZHANG Yujun . Effect of glucocorticoids on eotaxin expression in nasal polyps [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 21-23 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 84 -87 .
[2] NIU Shanli,CHAI Maowen,LI Zhenxiu . Endoscopic rhinoplasty of inferior turbinate in 60 patients with chronic hypertrophic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 16 -18 .
[3] MENG Qing-guo,LU Yong-tian,FAN Xian-liang .

Association of killer cell immunoglobulin-like receptor gene polymorphisms with nasopharyngeal carcinoma

[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 196 -199 .
[4] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 199 -199 .
[5] WAN Li-jia,LU Hai-tao,JIANG Yi-dao,LIU Hui,LI Qin,SHE La-zhi . Effect of H-uvulopalatopharyngoplasty on obstructive sleep apnea
hypopnea syndrome
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 204 -205 .
[6] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 222 -224 .
[7] JI Xiao-bin,DENG Jia-de,ZANG Lin-quan,WANG Lei,XIE Jun . Blood histamine in guinea pigs with allergic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 228 -230 .
[8] XIANG Deng,LU Yong-tian,SUN Huan-ji . Endoscopic repair for cerebrospinal fluid rhinorrhea in 19 cases and a literature review [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 234 -236 .
[9] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 253 -257 .
[10]
YIN Guo-hua,ZHONG Xiao . Long-term effect of laser reduction on lingua adenoids
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 280 -282 .