A Case Report of Phialemonium Curvatum Endophthalmitis

Abstract

Endophthalmitis caused by Phialemonium species are rare. We report a 68-year-old female with unilateral Phialemonium curvatum endophthalmitis. She presented with a two day history of right-sided floaters and reduced vision to finger counting, initially treated as iridocyclitis with topical and systemic steroids. Due to worsening, a diagnostic vitrectomy was performed. The culture from the vitreous cavity yielded Phialemonium curvatum growth. She was treated with amphotericin B intravitreally once and voriconazole tablets for three months with gain of Best Corrected Visual Acuity (BCVA) to 0.3. Six weeks following discontinuation of voriconazole, the patient developed right-sided eye pain and deterioration of the visual acuity. A second diagnostic vitrectomy was performed and once again the culture demonstrated growth of Phialemonium curvatum. She was treated with voriconazole for six months. Further, she developed eye pain and reduced vision in her right eye about 2 years following the second diagnostic vitrectomy. A third diagnostic vitrectomy was performed which was negative. Two weeks following the third diagnostic vitrectomy, the patient presented with retinal detachment and macular hole in the same eye. Retinal detachment persisted even following surgical repair with silicone insertion. The patient declined further surgeries. About ten years following initial presentation she developed intolerable right-sided eye pain and phthisis. The eye was eviscerated.