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LETTER TO EDITOR
Year : 2006  |  Volume : 54  |  Issue : 1  |  Page : 65-66

Curvularia lunata endophthalmitis presenting with a posterior capsular plaque


L.V. Prasad Eye Institute, L.V. Prasad Marg, Banjara Hills, Hyderabad - 500034, India

Correspondence Address:
Avinash Pathengay
Smt Kanuri-Santhamma Retina Vitreous Centre, L.V. Prasad Eye Institute, L.V. Prasad Marg, Banjara Hills, Hyderabad - 500034
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.21625

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How to cite this article:
Pathengay A, Shah GY, Das T, Sharma S. Curvularia lunata endophthalmitis presenting with a posterior capsular plaque. Indian J Ophthalmol 2006;54:65-6

How to cite this URL:
Pathengay A, Shah GY, Das T, Sharma S. Curvularia lunata endophthalmitis presenting with a posterior capsular plaque. Indian J Ophthalmol [serial online] 2006 [cited 2020 Jun 3];54:65-6. Available from: http://www.ijo.in/text.asp?2006/54/1/65/21625

Dear Editor,

Dematiaceous fungi rarely cause endophthalmitis following cataract surgery or keratitis.[1],[2],[3],[4] Curvularia lunata , one of the dematiaceous fungi, has been reported to cause delayed endophthalmitis with fluffy abscess in the anterior chamber.[4] We report a case of C. lunata endophthalmitis that presented following cataract surgery as a posterior capsular plaque.

A 54-year-old female presented with gradual decrease in vision in the right eye of 2 months duration following an extracapsular cataract extraction and posterior chamber Intraocular lens implantation 3 months ago. Her best corrected visual acuity was counting fingers at 1 meter in the right eye and 20/100 in the left eye. The right eye had 2+ cells in the anterior chamber with a plaque on the posterior capsule. [Figure - 1] The left eye had posterior subcapsular cataract. Fundus examination of the right eye revealed mild vitreous haze and normal retina.

She underwent pars plana vitrectomy with posterior capsulectomy and intraocular injection of vancomycin (1 mg / 0.1 ml), ceftazidime (2.25 mg / 0.1 ml), and amphotericin B (0.005 mg / 0.1 ml). Vitreous microscopy showed brown, septate fungal filaments. Vitreous culture on Sabouraud dextrose agar showed growth of fluffy grayish black colony [Figure - 2]a which was identified as Curvularia lunata based on characteristic curved spores [Figure - 2]b.

She was treated with topical 5% natamycin 10 times/day and oral itraconazole 100 mg twice a day for 4 weeks. Baseline liver function tests, at the end of 4 weeks, were within normal limits. Post-operatively, vision improved to 20/40 by one week with decrease in inflammation. Best corrected visual acuity at one month was 20/30 which maintained till her last follow-up at 7 months.

Previous report of chronic endophthalmitis with Alternaria alternata , a type of dematiaceous fungus, did not reveal a capsular plaque but showed fungal filament infiltration into the posterior capsule on histology.[1] To our knowledge (Medline search), this is the first case of C. lunata endophthalmitis presenting as a posterior capsular plaque and second case of chronic endophthalmitis caused by C. lunata .[4] Good visual recovery was noted in our case compared to previous reports. [1],[2],[3],[4]Posterior capsular plaque with chronic endophthalmitis could be a rare clinical manifestation of infection due to C. lunata.

 
  References Top

1.
Rummelt V, Ruprecht KW, Boltze HJ, Naumann GO. Chronic Alternaria alternata endophthalmitis following intraocular lens implantation. Arch Ophthalmol 1991;109:178.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.
Holting-Lima AL, Freitas D, Fischman O, Roizenblatt R, Belfort R. Exophialia jeanslelmei causing late endophthalmitis after cataract surgery. Am J Ophthalmol 1999;128:512-4.  Back to cited text no. 2
    
3.
Borderie VM, Bourcier TM, Poirot J-LP, Baudrimont M, Prudhomme de Saint-Maur P, Laroche L. Endophthalmitis after Lasiodiplodia theobomae corneal abscess. Graefe's Arch Clin Exp Ophthalmol 1997; 235:259-69.  Back to cited text no. 3
    
4.
Kaushik S, Ram J, Chakrabarty A, Dogra MR, Brar GS, Gupta A. Curvularia lunata endophthalmitis with secondary keratitis. Am J Ophthalmol 2001;131:140-2.  Back to cited text no. 4
[PUBMED]  [FULLTEXT]  


    Figures

  [Figure - 1], [Figure - 2]


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