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R. Bloom, M. Szlechter, U. Mian, M. Levi, H. Engel; A Case of Endogenous Fungal Endophthalmitis Caused by Paecilomyces Lilacinus in a Patient With No Other Clinical Signs of Infection. Invest. Ophthalmol. Vis. Sci. 2007;48(13):688.
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The purpose of this case report is three-fold: 1) to report the first known case of endogenous fungal endophthalmitis caused by Paecilomyces lilacinus; 2) to highlight the efficacy of intravitreal voriconazole in the treatment of Paecilomyces; and 3) to emphasize the role of genetic PCR in the management of fungal endophthalmitis.
Retrospective case report.
A 48-year-old patient with HIV, on Highly Active Anti-Retroviral Therapy (HAART), presented with fungal endophthalmitis. The patient had no history of ocular trauma or surgery and had no clinical signs of extraocular infection. The identity of the fungus was determined using genetic PCR and was identified as Paecilomyces lilacinus. The infection was successfully treated with intravitreal voriconazole.
Although not previously described, endogenous fungal endophthalmitis may develop without systemic or extraocular signs of infection. Intravitreal voriconazole may be the most efficacious treatment for fungal endophthalmitis. Genetic PCR testing is an invaluable tool for identifying fungi, but is not commonly employed. Based on our experience, genetic PCR testing is a useful adjunct in management of fungal endophthalmitis.
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