Endogenous Pseudoallescheria boydii endophthalmitis: A clinicopathologic report

Stern, R. M.; Zn, Zakov; Dm, Meisler; Gs, Hall; Martin, A

doi:10.3949/ccjm.53.2.197

Cited by 14 publications

(6 citation statements)

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“…Therapeutic levels of mi¬ conazole are easily obtained in blood and spinal fluid with systemic thera¬ py,4 but even intravitreal instillation of miconazole in the treatment of boy¬ dii endophthalmitis has met with mixed results. 6,8 In the current cases, intravitreal instillation of miconazole or amphoteri¬ cin was coupled with systemic treat¬ ment with fluconazole, a triazole antifungal.9 The fluconazole minimum inhibitory concentration of the boy¬ dii isolate from case 1 was 5.0 mg/L, and serum and cerebrospinal fluid con¬ centrations of 8.3 and 7.25 mg/L, re¬ spectively, were obtained on the initial dose of 400 mg orally every day. Ther¬ apeutic levels of fluconazole in the eye were more difficult to achieve; simulta¬ neous measurements showed the vitre¬ ous drug concentration to be only 55% of the serum drug concentration.…”

mentioning

confidence: 92%

Endogenous Pseudallescheria boydii Endophthalmitis

et al. 1991

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mentioning

confidence: 92%

Endogenous Pseudallescheria boydii Endophthalmitis

et al. 1991

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“…has been reported extensively (112,130,236,261,283,335,417). Endophthalmitis can be classified depending on how the microorganism reaches the deeper ocular tissues, as endogenous (via hematogenous dissemination to the eye) or exogenous (via direct introduction of the fungus during eye trauma or surgery or from preexisting scleritis or keratitis).…”

Section: Ii) Extrapulmonary Infections (A) Cutaneous and Subcutaneoumentioning

confidence: 99%

“…drug users (67,130,133,259,283,335,451,482). P. boydii has been identified as the etiologic agent in a case of endogenous endophthalmitis from an infected porcine allograft of the aortic valve (417) and even in a patient without recognizable risk factors (324).…”

Section: Ii) Extrapulmonary Infections (A) Cutaneous and Subcutaneoumentioning

confidence: 99%

Infections Caused byScedosporiumspp

et al. 2008

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SUMMARY Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii in patients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.

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“…As mentioned in connection with C. albicans, endogenous endophthalmitis may occur from fungi seeding the bloodstream from a catheter or endocarditis. Pseudallescheria boydii has caused endophthalmitis from an infected porcine allograft of the aortic valve (259) and even in a patient without risk factors for the disease (193).…”

Section: Bloodborne Infections: Endogenous Endophthalmitismentioning

confidence: 99%