Posters

The unknown enemy: diagnostic difficulties in the fungal uveitis

Poster Details

First Author: K.Zimmer POLAND

Co Author(s):    M. Mimier-Janczak   H. Zając - Pytrus   J. Adamiec - Mroczek   I. Helemejko   A. Turno - Kręcicka        

Abstract Details

Purpose:

The given poster presents the case of the 35-year-old patient who has been hospitalized in the Department of Ophthalmology in Wrocław due to severe uveitis of the right eye. The patient has been treated since April 2019 for the symptoms of acute right eye iritis.

Setting:

The main symptom at the first admission to the Clinic in Wroclaw in May this year was a massive effusion occupying 2/3 of the anterior chamber and the vitreous chamber of the right eye. The patient's visual acuity on admission were the hand movements in front of the eye.

Methods:

The anterior chamber was rinsed several times with biopsy for bacteria culture inoculation, followed by vitrectomy with removal of exudate masses and lens masses, during which the gas was administered to the vitreous chamber, with subsequent silicon oil 5000 administration. Due to the recurrent nature of inflammation, inflammatory material was taken from the anterior chamber of the right eye for pathogen diagnosis. In microbiological culture, a difficult-growing fungal pathogen sensitive to voriconazole was diagnosed. Intensive targeted antibiotic therapy was implemented with amphotericin B and voriconazole in injections into the anterior chamber, subconjunctival injections and in eye drops.

Results:

As a result of the treatment, inflammatory infiltration from the anterior chamber and the cornea was resolved followed with intense ingrowth of the vessels into the cornea. The patient was discharged from the Clinic with recommendations for using drops of Voriconazole every 2 hours, Oftaquix 3 times a day and Atropine 5 times a day to the right eye.

Conclusions:

Currently, the patient is regularly monitored in the Outpatient Clinic. Symptoms most likely indicate the initial process of eyeball atrophy. Fungal eye inflammation is one of the most severe infectious conditions that varies greatly. Effective treatment still remains a major therapeutic challenge.

Financial Disclosure:

None