Endogenous Pseudoallescheria boydii endophthalmitis

ABSTRACT

The authors describe the clinicopathologic findings in a case of endogenous Pseudoallescheria boydii endophthalmitis that developed in a 31-year-old man following aortic valve replacement and aortic prosthetic graft insertion. The patient died from disseminated P boydii infection. The fungus was resistant to amphotericin B in vitro. Postmortem histologic and microbiologic studies suggested that the combination of pars plana vitrectomy and intravitreal instillation of miconazole (40 ng) had eradicated the organism from the vitreous cavity. In other instances of fungal endophthalmitis where isolates are resistant to amphotericin B, intravitreal miconazole and vitrectomy may be useful.