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TitleA Difficult Case: Chronic Post-operative Endophthalmitis (Fungal)
PurposeTo report a case of Chronic Post-Operative Endophthalmitis and describe the decision making on fungal-causative management
MethodsThis case report was conducted from a patient of ophthalmology clinic. Diagnosis was based on history taking, ocular examinations, microbiology culture and progression of the disease. Management was chosen based on clinical progression of the disease
ResultsA 51-year-old male came to the clinic with chief complaint of blurred vision, redness, and pain on right eye since 2 weeks ago. The patient has a history of cataract surgery since 9 weeks ago. Visual acuity was hand movement in the RE and 20/20 in the LE. Examination of RE showed eyelid swelling, conjunctival and pericorneal injection. There were edema, hazy and stromal defect in cornea, also hypopyon, flare, and cells in anterior chamber. Ocular ultrasound on RE showed vitreous opacities. Patient was diagnosed with chronic post-operative endophthalmitis, received systemic and topical antibiotics, topical steroid, and performed vitrectomy with intravitreal antibiotics injection. Inflammatory episode recurred twice and the visual acuity was decreasing. The result of microbiology culture of vitreous sample was no microbial growth. We suspected fungal as a cause, then patient was given topical and systemic Voriconazole for six months, then the clinical signs and symptoms were improving
ConclusionThe diagnosis was concluded from clinical suspicion based on ocular findings. Delayed onset of ocular manifestation was consistent for the chronic endophthalmitis. Good response after Voriconazole treatment indicated fungal as a cause
Conflict of interestNo
Authors 1
Initials of first name(s)S
Authors 2
Last nameALDINA
Initials of first name(s)R