Purpose
To report a case series of Curvularia endophthalmitis and to determine the number of Curvularia positive corneal cultures at a single academic center in five year increments from January 1, 1980 to October 17, 2012.
Methods
Retrospective review of Bascom Palmer Eye Institute microbiology archives and patient charts for demographic information, clinical features, etiology, treatment, and outcomes in Curvularia endophthalmitis. The number of corneal cultures positive for Curvularia in five year increments was determined.
Results
Seven adult patients with exogenous Curvularia endophthalmitis (4 post-operative, 3 posttraumatic) were seen between 1980 and 2012. In 3 cases the endophthalmitis followed trauma. In 4 postoperative cases, patients became symptomatic 2-5 months following surgery and the time to definitive diagnosis ranged from 7-19 months. In post-operative cases, successful treatment was achieved 8-25 months following the original surgery and often required surgical removal of an infectious nidus, in addition to the lens capsule. When assessed by five-year increments, the number of Curvularia keratitis cases increased over the study period. No cases of Curvularia keratitis were seen between 1980 and 1984, while 30 cases were seen between 2005 and 2009.
Conclusions
The incidence of Curvuleria keratitis increased from 1980 to 2009 in an academic center. In postoperative endophthalmitis cases, patients typically present with chronic inflammation and the diagnosis requires a high index of suspicion as it can be difficult to establish. Definitive treatment often requires removal of an infectious nidus, in addition to removal of the lens capsule.
Keywords: 513 endophthalmitis •
530 fungal disease •
573 keratitis