Successful treatment of Fusarium endophthalmitis with voriconazole and Aspergillus endophthalmitis with voriconazole plus caspofungin

Marlene L. Durand, Ivana K. Kim, Donald J. D'Amico, John I. Loewenstein, Ellis H. Tobin, Shalom J. Kieval, Stephen S. Martin, Dimitri T. Azar, Frederick S. Miller, Brandon J. Lujan, Joan W. Miller

Research output: Contribution to journalArticle

67 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)552-554
Number of pages3
JournalAmerican journal of ophthalmology
Volume140
Issue number3
DOIs
StatePublished - Sep 2005
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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    Durand, M. L., Kim, I. K., D'Amico, D. J., Loewenstein, J. I., Tobin, E. H., Kieval, S. J., Martin, S. S., Azar, D. T., Miller, F. S., Lujan, B. J., & Miller, J. W. (2005). Successful treatment of Fusarium endophthalmitis with voriconazole and Aspergillus endophthalmitis with voriconazole plus caspofungin. American journal of ophthalmology, 140(3), 552-554. https://doi.org/10.1016/j.ajo.2005.03.030