A Case of Intravitreal Voriconazole for the Treatment of Drug-resistant Penicillium Endophthalmitis

Sung Bok Lee; Chang Jun Park; Jung Yeul Kim

doi:10.3341/jkos.2007.48.11.1583

Journal List > J Korean Ophthalmol Soc > v.48(11) > 1007975

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Lee, Park, and Kim: A Case of Intravitreal Voriconazole for the Treatment of Drug-resistant Penicillium Endophthalmitis

Original Article

J Korean Ophthalmol Soc 2007;48(11):1583-1587.

Published online: 28 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.11.1583

A Case of Intravitreal Voriconazole for the Treatment of Drug-resistant Penicillium Endophthalmitis

Sung Bok Lee, M.D.^1,², Chang Jun Park, M.D.¹, Jung Yeul Kim, M.D.^1,^3,

¹Department of Ophthalmology, College of Medicine, Chungnam National University, Daejeon, Korea

²Cancer Research Institute, Chungnam National University Hospital, Research Institute for Medical Science, Daejeon, Korea

³Chungnam National University, Daejeon, Korea

Address reprint requests to Jung yeul Kim, M.D., Department of Ophthalmology, Chungnam National University Hospital, #640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea, Tel: 82-42-280-8433, Fax: 82-42-255-3745, E-mail: kimjy@cnu.ac.kr

Received 17 April 2007 Accepted 31 July 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of a drug-resistant Penicillium endophthalmitis that was treated with intravitreal voriconazole injection.

Case summary

A 73-year-old male who developed endophthalmitis after cataract surgery was treated with intravitreal vancomycin and ceftazidime injection after aqueous and vitreous cultures were done. The condition were not improve after intravitreal injection, and the culture showed Penicillium species. Fungal endophthalmitis was diagnosed and pars plana vitrectomy, intraocular lens removal, and intravitreal amphotericin B injection were performed. However, a progressive worsening of the ocular condition was observed, and the patient was transferred to our hospital. At initial visit, the best corrected visual activity was hand movement. The hypopyon and thick exudative membrane filled the anterior chamber. Pars plana vitrectomy and intravitreal voriconazole injection were performed under the diagnosis of drug-resistant Penicillium endophthalmitis. The condition improved after the operation, and there was no recurrence of endophthalmitis until four months after vitrectomy.

Conclusions

Voriconazole is useful in the treatment of drug-resistant fungal endophthalmitis.

Keywords: Fungal endophthalmitis, Penicillium endophthalmitis, Voriconazole

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Figure 1.

Photographs at the initial visit to our hospital. (A) Hypopyon and thick exudative membrane had filled in the anterior chamber. (B) The B scan ultrasonograph shows high echogenicity in the vitreous cavity.

Figure 2.

Photographs at 4 months after vitrectomy and intravitreal voriconazole injection. (A) Inflammatory reaction in the anterior chamber nearly disappeared. (B) Fundus photograph. Vitreous opacity nearly disappeared.

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