Scedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review

Todokoro, Daisuke; Hoshino, Junki; Yo, Ayaka; Makimura, Koichi; Hirato, Junko; Akiyama, Hideo

doi:10.1186/s12886-018-0707-4

Cited by 26 publications

(25 citation statements)

References 29 publications

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“…Infectious scleritis is a rare complication of sub‐Tenon TA with a reported incidence of 0.04% . A recent review found nine reported cases in which four were caused by fungal organisms …”

Section: Complications Of Ocular and Periocular Steroid Deliverymentioning

confidence: 99%

Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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Locally administered steroids have a long history in ophthalmology for the treatment of inflammatory conditions. Anterior segment conditions tend to be treated with topical steroids whilst posterior segment conditions generally require periocular, intravitreal or systemic administration for penetration. Over recent decades, the clinical applications of periocular steroid delivery have expanded to a wide range of conditions including macular oedema from retino-vascular conditions. Formulations have been developed with the aim to provide practical, targeted, longer-term and more efficacious therapy whilst minimizing side effects. Herein, we provide a comprehensive overview of the

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“…Infectious scleritis is a rare complication of sub‐Tenon TA with a reported incidence of 0.04% . A recent review found nine reported cases in which four were caused by fungal organisms …”

Section: Complications Of Ocular and Periocular Steroid Deliverymentioning

confidence: 99%

Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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“…[ 74 ] The most common fungi that may cause scleritis are filamentous fungi. Aspergillus flavus is the most frequent fungus isolated, but several other species can cause infection[ 75 76 77 78 ]…”

Section: Types Of Infectious Scleritismentioning

confidence: 99%

Scleritis: Differentiating infectious from non-infectious entities

Murthy

Sabhapandit

Balamurugan

et al. 2020

Indian J Ophthalmol

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Scleritis is a rare painful ocular disorder, associated with severe ocular pain and tissue destruction. Although a majority of these cases are immune mediated and at least half of these are associated with systemic immune-mediated diseases, a smaller minority are due to infections of the sclera. The two conditions closely mimic each other, and a thorough knowledge of the subtle differences is necessary in order to reach a timely diagnosis. Diagnostic delay can lead to a poor outcome both due to the destruction caused by the uncontrolled infection and also due to propagation of the infection with the use of corticosteroids which may have been started for presumed immune mediated scleritis. In this review, we present the clinical features, etiological agents, and the differentiating features between immune and infectious scleritis. We also present diagnostic and management guidelines for managing scleral infection.

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“…Subtenon injection of triamcinolone acetonide (STTA) has been widely adopted to treat macular oedema secondary to diabetic retinopathy, branch retinal vein occlusion (BRVO), and uveitis. Although infectious complications following STTA are uncommon, endophthalmitis [21], scleritis [22,23], and orbital abscess [21,[24][25][26][27][28] have been reported. Furthermore, only two cases of fungal orbital abscess following STTA were found to have been reported so far [21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Orbital abscess caused by Exophiala dermatitidis following posterior subtenon injection of triamcinolone acetonide: a case report and a review of literature related to Exophiala eye infections

et al. 2020

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Background: Subtenon injection of triamcinolone acetonide (STTA) has been widely adopted in the clinical setting of ophthalmology and its infectious complications are rare. However, orbital abscess following STTA has been reported in seven cases. Furthermore, although eye infections due to Exophiala species are uncommon, there have been 19 cases to date. E. jeanselmei, E. phaeomuriformis, E. werneckii, and E. dermatitidis have been reported to cause human eye infections; however, to the best of our knowledge, orbital abscess caused by E. dermatitidis has not yet been reported. We describe the first documented case of fungal orbital abscess caused by E. dermatitidis following STTA. We also review the related literature of orbital abscess following STTA, as well as eye infections caused by the four Exophiala species. Case presentation: The patient was a 69-year-old Japanese woman with diabetic mellitus. She had a macular oedema in her right eye, which occurred secondary to branch retinal vein occlusion. An orbital abscess caused by E. dermatitidis occurred 4 months after the second STTA for the macular oedema, which was successfully treated by a surgical debridement and systemic administration of voriconazole. Conclusions: Our findings in the patient and from our literature survey caution ophthalmologists to the fact that STTA can cause fungal orbital infections, especially in diabetic patients. Furthermore, surgical treatment is one of the most important risk factors.

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Scedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review

Cited by 26 publications

References 29 publications

Local delivery of corticosteroids in clinical ophthalmology: A review

Local delivery of corticosteroids in clinical ophthalmology: A review

Scleritis: Differentiating infectious from non-infectious entities

Orbital abscess caused by Exophiala dermatitidis following posterior subtenon injection of triamcinolone acetonide: a case report and a review of literature related to Exophiala eye infections

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