Seminars in ophthalmology · 2013
Resolution of Coccidioides immitis endophthalmitis with an aggressive surgical and medical therapeutic approach.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Reed David C, Shah Kayur H, Hubschman Jean-Pierre
Аннотация
INTRODUCTION: Coccidioides immitis endophthalmitis usually results in enucleation, and there is evidence that vitrectomized eyes are more likely to become enucleated.
METHODS: A 55-year-old man presented to us with steroid-resistant granulomatous uveitis and was eventually diagnosed with C. immitis endophthalmitis. He was treated with an aggressive medical and surgical approach, receiving a total of 16 intravitreal antifungal injections and three vitrectomies, as well as lensectomy and penetrating keratoplasty.
RESULTS: At 13 months after presentation, the patient's eye was free of inflammation, and his best corrected visual acuity was 20/25.
DISCUSSION: This is the first reported case of culture-proven C. immitis endophthalmitis with a favorable final outcome. We propose that the good outcome may have been due to our aggressive therapeutic approach.
METHODS: A 55-year-old man presented to us with steroid-resistant granulomatous uveitis and was eventually diagnosed with C. immitis endophthalmitis. He was treated with an aggressive medical and surgical approach, receiving a total of 16 intravitreal antifungal injections and three vitrectomies, as well as lensectomy and penetrating keratoplasty.
RESULTS: At 13 months after presentation, the patient's eye was free of inflammation, and his best corrected visual acuity was 20/25.
DISCUSSION: This is the first reported case of culture-proven C. immitis endophthalmitis with a favorable final outcome. We propose that the good outcome may have been due to our aggressive therapeutic approach.