Cerebral Basilar Artery Mycotic Aneurysm Associated With Aspergillus Endogenous Endophthalmitis

Mee Yon Lee; Woong Joo Whang; Won Ki Lee

doi:10.3341/jkos.2010.51.12.1671

Journal List > J Korean Ophthalmol Soc > v.51(12) > 1008720

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Lee, Whang, and Lee: Cerebral Basilar Artery Mycotic Aneurysm Associated With Aspergillus Endogenous Endophthalmitis

Original Article

J Korean Ophthalmol Soc 2010;51(12):1671-1675.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.12.1671

Cerebral Basilar Artery Mycotic Aneurysm Associated With Aspergillus Endogenous Endophthalmitis

Mee Yon Lee, MD, Woong Joo Whang, MD, Won Ki Lee, MD, PhD

Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea

Address reprint requests to Won Ki Lee, MD, PhD Department of Ophthalmology, Seoul St. Mary's Hospital #505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea Tel: 82-2-2258-6198, Fax: 82-2-599-7405, E-mail: wklee@catholic.ac.kr

Received 18 February 2010 Accepted 11 October 2010

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 mycotic aneurysm of the cerebral basilar artery associated with bilateral endogenous aspergillus endophthalmitis.

Case summary

A 41-year-old man with no underlying disease presented with decreased vision in both eyes. The patient was diagnosed with bilateral endogenous endophthalmitis, and the authors performed a vitrectomy and lensectomy on the right eye. Hyphae were detected in the vitreous sample, and systemic amphotericin was administered. Three days after the operation, the patient became comatose due to a subarachnoid hemorrhage. Aspergillus antigen was detected in the vitreous sample and in the cerebrospinal fluid. Subarachnoid hemorrhage was due to the rupture of a mycotic aneurysm of the cranial basilar artery, complicated by aspergillus infection of the central nervous system.

Keywords: Aspergillus endophthalmitis, Endogenous endophthalmitis, Mycotic aneurysm

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Figure 1.

Fundus photograph of right eye (A), and left eye (B) at the initial visit. Bilateral severe iniflammation with massive yellowish abscess is found.

Figure 2.

The ultrasonographic findings of right eye (A), and left eye (B) at the initial visit. Increased vitreous reflectivity due to inflammatory reaction is found in both eye.

Figure 3.

Brain CT shows aneurysm of the Basilar Artery with irregular arterial surface (arrow).

Figure 4.

KOH smear of cerebrospinal fluid shows fungal hyphae.

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