American journal of ophthalmology · 2005
Successful treatment of Fusarium endophthalmitis with voriconazole and Aspergillus endophthalmitis with voriconazole plus caspofungin.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Durand Marlene L, Kim Ivana K, D'Amico Donald J, Loewenstein John I, Tobin Ellis H, Kieval Shalom J, Martin Stephen S, Azar Dimitri T, Miller Frederick S, Lujan Brandon J, Miller Joan W
Аннотация
PURPOSE: To report successful treatment of exogenous Fusarium and Aspergillus endophthalmitis with new antifungal agents.
DESIGN: Interventional case report.
METHODS: Treatment of two cases is reviewed.
RESULTS: A 64-year-old man developed post-cataract Fusarium moniliforme endophthalmitis. Infection persisted despite removal of the intraocular lens, three vitrectomies, and five intravitreal injections of amphotericin. Inflammation resolved and vision improved from 20/80 to 20/40 on 6 months of oral voriconazole. A 55-year-old man developed post-cataract intraocular inflammation. After three vitrectomies and removal of the intraocular lens, Aspergillus fumigatus endophthalmitis was diagnosed. Intravitreal amphotericin and systemic voriconazole were given, but one week later there were early signs of recurrence. Intravenous caspofungin was added and the eye improved. Caspofungin was continued for 6 weeks and voriconazole for 6 months. Vision improved from counting fingers to 20/80 at 6 months and 20/25 at 23 months.
CONCLUSION: Voriconazole is a promising new therapy for Fusarium and Aspergillus endophthalmitis. Caspofungin may act synergistically with voriconazole in treating Aspergillus endophthalmitis.
DESIGN: Interventional case report.
METHODS: Treatment of two cases is reviewed.
RESULTS: A 64-year-old man developed post-cataract Fusarium moniliforme endophthalmitis. Infection persisted despite removal of the intraocular lens, three vitrectomies, and five intravitreal injections of amphotericin. Inflammation resolved and vision improved from 20/80 to 20/40 on 6 months of oral voriconazole. A 55-year-old man developed post-cataract intraocular inflammation. After three vitrectomies and removal of the intraocular lens, Aspergillus fumigatus endophthalmitis was diagnosed. Intravitreal amphotericin and systemic voriconazole were given, but one week later there were early signs of recurrence. Intravenous caspofungin was added and the eye improved. Caspofungin was continued for 6 weeks and voriconazole for 6 months. Vision improved from counting fingers to 20/80 at 6 months and 20/25 at 23 months.
CONCLUSION: Voriconazole is a promising new therapy for Fusarium and Aspergillus endophthalmitis. Caspofungin may act synergistically with voriconazole in treating Aspergillus endophthalmitis.
Предметные рубрики MeSH
Anti-Bacterial AgentsAntifungal AgentsAspergillus fumigatusCaspofunginCataract ExtractionDrug Therapy, CombinationEchinocandinsEndophthalmitisEye Infections, FungalFusariumHumansLens Implantation, IntraocularLipopeptidesMaleMiddle AgedMycosesPeptides, CyclicPostoperative ComplicationsPyrimidinesTriazolesVitrectomyVoriconazole