Assuntos
Amiloide/metabolismo , Amiloidose/patologia , Corpo Ciliar/patologia , Mieloma Múltiplo/patologia , Neoplasias Uveais/patologia , Adulto , Amiloidose/diagnóstico por imagem , Amiloidose/metabolismo , Biomarcadores Tumorais/metabolismo , Antígenos CD79/metabolismo , Corpo Ciliar/diagnóstico por imagem , Corpo Ciliar/metabolismo , Feminino , Gonioscopia , Humanos , Cadeias kappa de Imunoglobulina/metabolismo , Cadeias lambda de Imunoglobulina/metabolismo , Neoplasias da Íris/diagnóstico por imagem , Neoplasias da Íris/metabolismo , Neoplasias da Íris/patologia , Glicoproteínas de Membrana/metabolismo , Mieloma Múltiplo/diagnóstico por imagem , Mieloma Múltiplo/metabolismo , Proteoglicanas/metabolismo , Sindecanas , Ultrassonografia , Neoplasias Uveais/diagnóstico por imagem , Neoplasias Uveais/metabolismoRESUMO
PURPOSE: To report a case of bilateral endogenous fungal endophthalmitis resulting from disseminated Scedosporium prolificans. DESIGN: Observational case report. METHODS: A 56-year-old woman with cystic fibrosis status post dual lung transplantation on chronic immunosuppressive therapy presented with acute graft rejection. Cultures of bronchial brushings revealed S. prolificans. Three weeks after admission, the patient noted increased blurriness and a central scotoma in her right eye. Dilated fundus examination revealed profound vitritis in the right eye with hemorrhagic retinitis involving the macula. A peripheral, yellow choroidal infiltrate with overlying retinitis and localized vitritis was present in the left eye. RESULTS: Intravitreal antibiotics were initiated, and vitreous cultures revealed S. prolificans. The patient ultimately succumbed to her disseminated disease. Pathologic examination of the eyes confirmed bilateral endogenous fungal endophthalmitis. CONCLUSION: S. prolificans is an opportunistic infection resistant to standard antifungal therapy that can result in endogenous endophthalmitis in immunocompromised individuals.