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Background <p>Here we describe a case of bilateral <i>Aspergillus</i> endophthalmitis occurring 4 months after bilateral cataract surgery, manifesting as a spectacular filamentary branching on the intraocular lens/capsular surface and difficulties in treatment.</p> Case presentation <p>A 66-year-old Iranian male patient with a known case of chronic lymphocytic leukemia, who had previously undergone bilateral cataract surgery during the same session 4&#xa0;months before, presented with a bilateral decrease in vision and vitreous haziness. The cytopathology results from vitreous sampling were negative for dysplastic cells. Still, the polymerase chain reaction analysis showed a positive result for <i>Aspergillus</i> sp., and a unique, striking filamentary branching growth appeared on the intraocular lens/capsular surface in both eyes. Treatment was challenging, with multiple vitrectomies and systemic and intravitreal anti-fungal agent treatment.</p> Conclusion <p>Challenges in managing bilateral <i>Aspergillus</i> endophthalmitis after cataract surgery in immunocompromised patients, diagnosis difficulties, voriconazole resistance, and the importance of early intervention are highlighted.</p>

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Bilateral Aspergillus endophthalmitis following cataract surgery: a diagnostic and therapeutic challenge—a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月3日

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  • Mohammadkarim Johari,
  • Mostafa Abuali,
  • Seyed Ahmad Razavizadegan,
  • Mehdi Moallem

摘要

Background

Here we describe a case of bilateral Aspergillus endophthalmitis occurring 4 months after bilateral cataract surgery, manifesting as a spectacular filamentary branching on the intraocular lens/capsular surface and difficulties in treatment.

Case presentation

A 66-year-old Iranian male patient with a known case of chronic lymphocytic leukemia, who had previously undergone bilateral cataract surgery during the same session 4 months before, presented with a bilateral decrease in vision and vitreous haziness. The cytopathology results from vitreous sampling were negative for dysplastic cells. Still, the polymerase chain reaction analysis showed a positive result for Aspergillus sp., and a unique, striking filamentary branching growth appeared on the intraocular lens/capsular surface in both eyes. Treatment was challenging, with multiple vitrectomies and systemic and intravitreal anti-fungal agent treatment.

Conclusion

Challenges in managing bilateral Aspergillus endophthalmitis after cataract surgery in immunocompromised patients, diagnosis difficulties, voriconazole resistance, and the importance of early intervention are highlighted.