967. Fusarium Endophtalmitis in Three Patients with Hematological Malignancies, and a Brief Review
Session: Poster Abstract Session: Clinical Mycology
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • IDSA_ABSTRACT_FUSARIUM.pdf (1.5 MB)
  • Background: 

    Fusarium species have recently come to fore as a common pathogenic mold next to Aspergillus in patients with hematogical malignancies. Infections due to Fusarium are a diagnostic difficulty just like Aspergillosis with the exception that blood cultures can aid in diagnosis of fusarial infection in 50% of  affected patients. Endogenous endophtalmitis is a known complication of disseminated fungal infections. 

    Methods: 

    We describe 3 patients with Fusarium endophthalmitis in H Lee Moffitt Cancer Center, from 1999 to 2010 highlighting their presentation, ophthalmological exam and treatment

    Results: 

    Case 1: 62 year old male with history of Hodgkin’s lymphoma, status post autologous peripheral stem cell transplantation. On day 10 he developed right foot redness, that was confirmed by biopsy to be Fusarium. Afterwards he developed a right eye conjunctival injection and blurry vision.  A large white retinal infiltrate breaking through the vitreous yielded Fusarium on vitreous culture. He was treated with intravitreal and systemic Amphotericin and systemic Posaconazole, vision improved but patient expired secondary to progression of  lymphoma.

    Case2: 66 year old male with history of AML admitted for induction. He was noted to have a purplish lesion on the right 5th toe, that evolved to osteomyelitis. He underwent amputation and cultures grew Fusarium. He then developed right eye conjunctivitis and a vitreous culture grew Fusarium. He received intravenous and intravitreous Ambisome and Voriconazole. He further developed retinal detachment, reattachment was attempted but failed and he ultimately underwent right eye enucleation. He received 1 year of Voriconazole, with no signs of recurrence.  

    Case 3: 46 year old male with ALL and CNS involvement, developed culture proven Fusarium sinusitis. He then had right eye conjunctivitis with blurry vision and ophthalmological exam revealed retinal lesions suspicious for fungal retinitis. He was treated with Ambisome, but as his CNS disease worsened, he was admitted to hospice care.

    Conclusion: 

    Eye symptoms in leukemic patients with prolonged neutropenia should prompt a thorough fundoscopic exam for early detection and timely initiation of appropriate systemic and intravitreal antifungal therapy.


    Subject Category: M. Mycology including clinical and basic studies of fungal infections

    Georgina Nasr, MD, Infectious Diseases, University of South Florida, Tampa, FL, Peter Pavan, MD, Ophtalmology, University of South Florida, Tampa, FL, Sharad Malvade, MD, MPH, Global Health, Communicable Diseases, University of South Florida, Tampa, FL, Mo Mai, MD, Ross University School of Medicine, North Brunswick, NJ and John Greene, MD, University of South Florida, Tampa, FL; H. Lee Moffitt Cancer Center, Tampa, FL

    Disclosures:

    G. Nasr, None

    P. Pavan, None

    S. Malvade, None

    M. Mai, None

    J. Greene, None

    See more of: Clinical Mycology
    See more of: Poster Abstract Session

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.