CHALLENGES IN THE MANAGEMENT OF PRESUMED FUNGAL ENDOPHTHALMITIS IN PREGNANCY.


Journal

Retinal cases & brief reports
ISSN: 1937-1578
Titre abrégé: Retin Cases Brief Rep
Pays: United States
ID NLM: 101298744

Informations de publication

Date de publication:
01 Jul 2021
Historique:
pubmed: 26 7 2018
medline: 1 12 2021
entrez: 26 7 2018
Statut: ppublish

Résumé

To report a rare case of endogenous endophthalmitis in pregnancy and the challenges of managing culture-negative fungal infection. Retrospective case report. A 30-year-old woman presented with a subfoveal chorioretinal lesion with vitritis and anterior chamber inflammation in the context of intravenous drug use. Spectral domain optical coherence tomography and fluorescein angiography were used for documentation and monitoring. After 2 months of systemic and intravitreal injections of amphotericin, the patient had clinical improvement in visual acuity, degree of inflammation, and in the size and activity of the chorioretinal lesion, which was presumed to be fungal in origin. Among limited cases of endophthalmitis in pregnancy, we report a challenging case of presumed fungal endogenous endophthalmitis. The patient responded favorably to intravitreal and systemic antifungal medications.

Identifiants

pubmed: 30045151
pii: 01271216-202107000-00013
doi: 10.1097/ICB.0000000000000811
doi:

Substances chimiques

Antifungal Agents 0

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

399-402

Références

Samiy N, D'Amico DJ. Endogenous fungal endophthalmitis. Int Ophthalmol Clin 1996;36:147–162.
Tirpack AR, Duker JS, Baumal CR. An outbreak of endogenous fungal endophthalmitis among intravenous drug abusers in New England. JAMA Ophthalmol 2017;135:534–540.
Sahu C, Kumar K, Sinha MK, et al. Review of endogenous endophthalmitis during pregnancy including case series. Int Ophthalmol 2013;33:611–618.
Binder MI, Chua J, Kaiser PK, et al. Endogenous endophthalmitis: an 18-year review of culture-positive cases at a tertiary care center. Medicine (Baltimore) 2003;82:97–105.
Liu K, Fang F, Li H. Reliability of vitreous histological detection of pathogenic fungi in the diagnosis of fungal endophthalmitis. Eye (Lond) 2015;29:424–427.
Lingappan A, Wykoff CC, Albini TA, et al. Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes. Am J Ophthalmol 2012;153:162–166.e1.
Cordioli RL, Cordioli E, Negrini R, Silva E. Sepsis and pregnancy: do we know how to treat this situation? [in Portuguese] Rev Bras Ter Intensiva 2013;25:334–344.
Cottreau JM, Barr VO. A review of antiviral and antifungal use and safety during pregnancy. Pharmacotherapy 2016;36:668–678.
Silva RA, Sridhar J, Miller D, et al. Exogenous fungal endophthalmitis: an analysis of isolates and susceptibilities to antifungal agents over a 20-year period (1990–2010). Am J Ophthalmol 2015;159:257–264.e1.

Auteurs

Alice Y Zhang (AY)

Johns Hopkins University, Wilmer Eye Institute, Baltimore, Maryland.
Department of Ophthalmology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina; and.

Christopher J Brady (CJ)

Johns Hopkins University, Wilmer Eye Institute, Baltimore, Maryland.
Division of Ophthalmology, University of Vermont, Burlington, Vermont.

Ashvini K Reddy (AK)

Johns Hopkins University, Wilmer Eye Institute, Baltimore, Maryland.

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Classifications MeSH