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Clinicopathologic Reports,Case Reports, and Small Case Series | June 2001

Exogenous Endophthalmitis Caused by Amphotericin B–Resistant Paecilomyces lilacinus: Treatment Options and Visual Outcomes

Ingrid U. Scott, MD, MPH; Harry W. Flynn, MD; Darlene Miller, MS, MPH; James W. Speights, MD; Robert C. Snip, MD; Roy D. Brod, MD

Arch Ophthalmol. 2001;119(6):916-919. doi:.

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Paecilomyces lilacinus, an uncommon cause of exogenous endophthalmitis, presents a challenging management problem since the organism is usually resistant to amphotericin B, the most commonly employed intravitreal antifungal, and natamycin, a frequently employed topical antifungal. The organism is sensitive to miconazole nitrate, ketoconazole, and, in some cases, fluconazole. We report 4 cases of endophthalmitis caused by P lilacinus and discuss treatment options.

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A 37-year-old man with endophthalmitis associated with a penetrating keratoplasty and supsequent wound leak. Examination demonstrates a visual acuity of 2/200 OS and a white flocculent mass on the cornea and extending into the anterior chamber. Intraocular cultures grew Paecilomyces lilacinus.

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Paecilomyces lilacinus growth on Sabouraud agar stained with Evans blue (aqueous specimen).

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Lactophenol blue preparation showing typical microscopic conidia and hyphae of Paecilomyces lilacinus.

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Scott IU, Flynn HW, Jr, Miller D, Speights JW, Snip RC, Brod RD. Exogenous Endophthalmitis Caused by Amphotericin B–Resistant Paecilomyces lilacinus: Treatment Options and Visual Outcomes. Arch Ophthalmol. 2001;119(6):916-919. doi:.

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Exogenous Endophthalmitis Caused by Amphotericin B–Resistant Paecilomyces lilacinus: Treatment Options and Visual Outcomes

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