ABSTRACT
Endoftalmite por Aspergillus é geralmente relacionada à disseminação local ou sistêmica do agente em indivíduos imunocomprometidos. Os autores relatam um caso raro de glaucoma bilateral grave secundário a uma infecção intra-ocular por Aspergillus niger, na ausência de qualquer foco detectável de aspergilose em paciente HIV-positivo. Foram afastados sinais e antecedentes de uso de drogas injetáveis e o agente foi isolado após inoculação em animais experimentais. Este caso demonstra que a endoftalmite por Aspergillus deve ser considerada em pacientes HIV-positivos não-usuários de drogas injetáveis, mesmo na ausência de aspergilose sistêmica.
Subject(s)
Humans , Female , Adult , AIDS-Related Opportunistic Infections/microbiology , Aspergillosis/microbiology , Aspergillus niger/isolation & purification , Endophthalmitis/microbiology , Glaucoma/microbiology , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Aspergillosis/diagnosis , Endophthalmitis/diagnosis , Glaucoma/diagnosis , Glaucoma/surgery , Severity of Illness IndexABSTRACT
Malignant Glaucoma due to Keratomycosis is a devastating and poorly recognised complication occurring in a small percentage of treated patients. It is characterized, in cases of Keratomycosis by a raised tension, uniform shallowing of the anterior chamber and a fungus-exudate-iris mass covering the pupillary area. Three cases of 'Keratomycotic Malignant Glaucoma' are discussed here. Two of these were successfully treated with therapeutic keratoplasty, extracapsular lens extraction and systemic antifungals. The development of malignant glaucoma after a therapeutic keratoplasty which occurred in one case has not previously been reported. All the three cases which developed malignant glaucoma had a pupillary size of 4 mm diameter or less and grew Fusarium from the cornea and anterior chamber.