An outbreak of Fusarium solani endophthalmitis after cataract surgery in an eye training and research hospital in Istanbul

Abstract

To report an outbreak of Fusarium solani endophthalmitis after uneventful cataract surgeries performed on the same day in the same operating room. Nine patients underwent phacoemulsification at 4th Clinic of Beyoglu Eye Training and Research Hospital in Istanbul. Cefuroxime axetyl was injected intracamerally from the same vial to all patients at the end of surgery. All patients developed acute postoperative endophthalmitis. Presentation, cultural studies, treatment, clinical responses and risk factors were evaluated. Cultural and DNA sequence findings revealed F. solani. Antifungal therapy was begun and pars plana vitrectomy, intraocular lens and capsule extraction were performed. Corneal involvement was correlated with old age and systemic disease. Fusarium solani should be considered in acute postoperative endophthalmitis. This infection can be controlled with early and aggressive combined antifungal and surgical treatment. The patients with corneal involvement had poor prognosis. It is important to use solutions prepared separately for each patient.

An outbreak of invasive fusariosis in a children’s cancer hospital

“…There have been various descriptions of outbreaks of keratitis due to contamination of contact lense products [17,18] and of endophtalmitis following cataract surgery [19,20].…”

Fungal endophthalmitis associated with compounded products

“…Prolonged time to diagnosis probably contributed to these poor outcomes; diagnostic delay might be explained by the rarity of fungal endophthalmitis and the resulting unfamiliarity of some physicians with this diagnosis, the subacute nature of early infection, or the difficulty of distinguishing true infection from the occasionally observed postprocedural sterile inflammation (19). Female sex was associated with case status among patients in the BBG cluster; however, sex differences have not been reported for prior clusters of Fusarium endophthalmitis patients (20,21). The association of diabetes mellitus with case status among patients in the triamcinolone cluster probably reflects the fact that multiple patients received these injections for complications associated with diabetes or that diabetes might have predisposed the patients to infection after exposure.…”

Causative Agents of Endophthalmitis in Turkey: An Overview

“…Dokuz hastada katarakt cerrahisi sonrası F. solani salgını ortaya çıkmıştır (32). Yine Fusarium türlerinin neden olduğu 8 olguluk bir salgın daha bildirilmiştir (33).…”