Fungal Endophthalmitis Secondary to Aspergillus terreus Exacerbated by Intravitreal Dexamethasone in a Patient With Sarcoidosis

J Vitreoretin Dis. 2023 May 24;7(5):448-454. doi: 10.1177/24741264231173207. eCollection 2023 Sep-Oct.

Abstract

Purpose: To report a case of Aspergillus terreus endophthalmitis associated with systemic immunosuppression and an intraocular steroid implant in a patient with sarcoidosis. Methods: A case report was evaluated and a literature review performed. Results: A patient with a history of pulmonary and ocular sarcoidosis presented with new-onset uveitis and was treated for presumed sarcoid flare with oral prednisone and an intravitreal dexamethasone implant before developing worsening vision. She was ultimately diagnosed with A terreus endophthalmitis. Despite both systemic and local antifungals, the visual acuity at the most recent follow-up was no light perception without pain or active inflammation. No definitive source of the fungal disease had been identified. Conclusions: Endophthalmitis resulting from A terreus is associated with poor outcomes. Given the ability of fungal endophthalmitis to mimic other causes of uveitis, one must maintain a high suspicion in patients with any degree of immunosuppression.

Keywords: Aspergillus terreus; endophthalmitis; sarcoidosis; uveitis.

Publication types

  • Case Reports