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Fungal endophthalmitis caused by Paecilomyces variotii following cataract surgery: a presumed operating room air‐conditioning system contamination
. Purpose: To report a case of delayed fungal endophthalmitis by Paecilomyces variotii following uncomplicated cataract surgery. To our knowledge this is the first reported case of postoperative endophthalmitis by this species. Methods: We report the longterm clinical follow‐up of an 83‐year‐old f...
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Published in: | Acta ophthalmologica Scandinavica 2004-04, Vol.82 (2), p.232-235 |
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creator | Tarkkanen, Ahti Raivio, Virpi Anttila, Veli‐Jukka Tommila, Petri Ralli, Reijo Merenmies, Lauri Immonen, Ilkka |
description | .
Purpose: To report a case of delayed fungal endophthalmitis by Paecilomyces variotii following uncomplicated cataract surgery. To our knowledge this is the first reported case of postoperative endophthalmitis by this species.
Methods: We report the longterm clinical follow‐up of an 83‐year‐old female who underwent uncomplicated sutureless, small‐incision cataract surgery. She developed recurring uveitis 4 months after surgery. Vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens were performed. Fungi were studied by histopathology and culture.
Results: At histopathological examination, the fungi were found to be closely related with the capsular bag. A few mononuclear inflammatory cells were encountered. At culture, Paecilomyces variotii, a common ubiquitous non‐pathogenic saprophyte, was identified. Despite systemic, intravitreal and topical antifungal therapy after vitrectomy the uveitis recurred several times, but no fungal organisms were isolated from the repeat intraocular specimen. At 18 months postoperatively the subject's visual acuity was finger counting at 2 metres. At the time of surgery the operating room air‐conditioning system was undergoing repairs. Cases of fungal endophthalmitis after contamination from air‐conditioning ventilation systems have been reported before, but none of the cases reported have been caused by P. variotii.
Conclusion: P. variotii, a non‐pathogenic environmental saprophyte, may be disastrous if introduced into the eye. International recommendations on the environmental control of the operating room air‐conditioning ventilation system should be strictly followed. No intraoperative surgery should be undertaken while the air‐conditioning system is undergoing repairs or service. |
doi_str_mv | 10.1111/j.1600-0420.2004.00235.x |
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Purpose: To report a case of delayed fungal endophthalmitis by Paecilomyces variotii following uncomplicated cataract surgery. To our knowledge this is the first reported case of postoperative endophthalmitis by this species.
Methods: We report the longterm clinical follow‐up of an 83‐year‐old female who underwent uncomplicated sutureless, small‐incision cataract surgery. She developed recurring uveitis 4 months after surgery. Vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens were performed. Fungi were studied by histopathology and culture.
Results: At histopathological examination, the fungi were found to be closely related with the capsular bag. A few mononuclear inflammatory cells were encountered. At culture, Paecilomyces variotii, a common ubiquitous non‐pathogenic saprophyte, was identified. Despite systemic, intravitreal and topical antifungal therapy after vitrectomy the uveitis recurred several times, but no fungal organisms were isolated from the repeat intraocular specimen. At 18 months postoperatively the subject's visual acuity was finger counting at 2 metres. At the time of surgery the operating room air‐conditioning system was undergoing repairs. Cases of fungal endophthalmitis after contamination from air‐conditioning ventilation systems have been reported before, but none of the cases reported have been caused by P. variotii.
Conclusion: P. variotii, a non‐pathogenic environmental saprophyte, may be disastrous if introduced into the eye. International recommendations on the environmental control of the operating room air‐conditioning ventilation system should be strictly followed. No intraoperative surgery should be undertaken while the air‐conditioning system is undergoing repairs or service.</description><identifier>ISSN: 1395-3907</identifier><identifier>EISSN: 1600-0420</identifier><identifier>DOI: 10.1111/j.1600-0420.2004.00235.x</identifier><identifier>PMID: 15043549</identifier><language>eng</language><publisher>Oxford, UK; Malden, USA: Blackwell Science Ltd/Inc</publisher><subject>Aged ; Aged, 80 and over ; Air Conditioning ; Air Microbiology ; Anti-Bacterial Agents ; cataract surgery ; Cross Infection ; Device Removal ; Drug Therapy, Combination - therapeutic use ; Endophthalmitis - diagnosis ; Endophthalmitis - drug therapy ; Endophthalmitis - microbiology ; Equipment Contamination ; Eye Infections, Fungal - diagnosis ; Eye Infections, Fungal - drug therapy ; Eye Infections, Fungal - microbiology ; Female ; fungal endophthalmitis ; Humans ; Lens Implantation, Intraocular ; Mycoses - diagnosis ; Mycoses - drug therapy ; Mycoses - microbiology ; Operating Rooms ; Paecilomyces ; Paecilomyces - isolation & purification ; Phacoemulsification ; postoperative endophthalmitis ; pseudophakic endophthalmitis ; Surgical Wound Infection - diagnosis ; Surgical Wound Infection - drug therapy ; Surgical Wound Infection - microbiology ; vitrectomy ; Vitreous Body - microbiology</subject><ispartof>Acta ophthalmologica Scandinavica, 2004-04, Vol.82 (2), p.232-235</ispartof><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4145-ad98d485a7169258bd1d1818e61f692412aff7d7618b1269da19f8948d28f2b93</citedby><cites>FETCH-LOGICAL-c4145-ad98d485a7169258bd1d1818e61f692412aff7d7618b1269da19f8948d28f2b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15043549$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tarkkanen, Ahti</creatorcontrib><creatorcontrib>Raivio, Virpi</creatorcontrib><creatorcontrib>Anttila, Veli‐Jukka</creatorcontrib><creatorcontrib>Tommila, Petri</creatorcontrib><creatorcontrib>Ralli, Reijo</creatorcontrib><creatorcontrib>Merenmies, Lauri</creatorcontrib><creatorcontrib>Immonen, Ilkka</creatorcontrib><title>Fungal endophthalmitis caused by Paecilomyces variotii following cataract surgery: a presumed operating room air‐conditioning system contamination</title><title>Acta ophthalmologica Scandinavica</title><addtitle>Acta Ophthalmol Scand</addtitle><description>.
Purpose: To report a case of delayed fungal endophthalmitis by Paecilomyces variotii following uncomplicated cataract surgery. To our knowledge this is the first reported case of postoperative endophthalmitis by this species.
Methods: We report the longterm clinical follow‐up of an 83‐year‐old female who underwent uncomplicated sutureless, small‐incision cataract surgery. She developed recurring uveitis 4 months after surgery. Vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens were performed. Fungi were studied by histopathology and culture.
Results: At histopathological examination, the fungi were found to be closely related with the capsular bag. A few mononuclear inflammatory cells were encountered. At culture, Paecilomyces variotii, a common ubiquitous non‐pathogenic saprophyte, was identified. Despite systemic, intravitreal and topical antifungal therapy after vitrectomy the uveitis recurred several times, but no fungal organisms were isolated from the repeat intraocular specimen. At 18 months postoperatively the subject's visual acuity was finger counting at 2 metres. At the time of surgery the operating room air‐conditioning system was undergoing repairs. Cases of fungal endophthalmitis after contamination from air‐conditioning ventilation systems have been reported before, but none of the cases reported have been caused by P. variotii.
Conclusion: P. variotii, a non‐pathogenic environmental saprophyte, may be disastrous if introduced into the eye. International recommendations on the environmental control of the operating room air‐conditioning ventilation system should be strictly followed. No intraoperative surgery should be undertaken while the air‐conditioning system is undergoing repairs or service.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Air Conditioning</subject><subject>Air Microbiology</subject><subject>Anti-Bacterial Agents</subject><subject>cataract surgery</subject><subject>Cross Infection</subject><subject>Device Removal</subject><subject>Drug Therapy, Combination - therapeutic use</subject><subject>Endophthalmitis - diagnosis</subject><subject>Endophthalmitis - drug therapy</subject><subject>Endophthalmitis - microbiology</subject><subject>Equipment Contamination</subject><subject>Eye Infections, Fungal - diagnosis</subject><subject>Eye Infections, Fungal - drug therapy</subject><subject>Eye Infections, Fungal - microbiology</subject><subject>Female</subject><subject>fungal endophthalmitis</subject><subject>Humans</subject><subject>Lens Implantation, Intraocular</subject><subject>Mycoses - diagnosis</subject><subject>Mycoses - drug therapy</subject><subject>Mycoses - microbiology</subject><subject>Operating Rooms</subject><subject>Paecilomyces</subject><subject>Paecilomyces - isolation & purification</subject><subject>Phacoemulsification</subject><subject>postoperative endophthalmitis</subject><subject>pseudophakic endophthalmitis</subject><subject>Surgical Wound Infection - diagnosis</subject><subject>Surgical Wound Infection - drug therapy</subject><subject>Surgical Wound Infection - microbiology</subject><subject>vitrectomy</subject><subject>Vitreous Body - microbiology</subject><issn>1395-3907</issn><issn>1600-0420</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><recordid>eNqNkcFu1TAQRS0EoqXwC8grdgm24yQ2YlNVtCBVKhKwtiax8-onJw620zY7PqELvpAvweE9wRZvPLpzZka6FyFMSUnze7svaUNIQTgjJSOEl4Swqi4fnqDTv42nua5kXVSStCfoRYx7Qogkgj1HJ7QmvKq5PEU_L5dpBw6bSfv5Nt2CG22yEfewRKNxt-LPYHrr_Lj2JuI7CNYna_HgnfP3dtplMkGAPuG4hJ0J6zsMeA4mLmOe97MJkDYseD9isOHXj8feTzof8dOmxzUmM-KsJRjtBJv-Ej0bwEXz6vifoW-XH75efCyub64-XZxfFz2nvC5AS6G5qKGljWS16DTVVFBhGjpkgVMGw9DqtqGio6yRGqgchORCMzGwTlZn6M1h7xz898XEpEYbe-McTMYvUbW0rWVLNlAcwD74GIMZ1BzsCGFVlKgtEbVXm_FqM15tiag_iaiHPPr6eGPpsiP_Bo8RZOD9Abi3zqz_vVid33zJRfUbXpyebw</recordid><startdate>200404</startdate><enddate>200404</enddate><creator>Tarkkanen, Ahti</creator><creator>Raivio, Virpi</creator><creator>Anttila, Veli‐Jukka</creator><creator>Tommila, Petri</creator><creator>Ralli, Reijo</creator><creator>Merenmies, Lauri</creator><creator>Immonen, Ilkka</creator><general>Blackwell Science Ltd/Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200404</creationdate><title>Fungal endophthalmitis caused by Paecilomyces variotii following cataract surgery: a presumed operating room air‐conditioning system contamination</title><author>Tarkkanen, Ahti ; Raivio, Virpi ; Anttila, Veli‐Jukka ; Tommila, Petri ; Ralli, Reijo ; Merenmies, Lauri ; Immonen, Ilkka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4145-ad98d485a7169258bd1d1818e61f692412aff7d7618b1269da19f8948d28f2b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Air Conditioning</topic><topic>Air Microbiology</topic><topic>Anti-Bacterial Agents</topic><topic>cataract surgery</topic><topic>Cross Infection</topic><topic>Device Removal</topic><topic>Drug Therapy, Combination - therapeutic use</topic><topic>Endophthalmitis - diagnosis</topic><topic>Endophthalmitis - drug therapy</topic><topic>Endophthalmitis - microbiology</topic><topic>Equipment Contamination</topic><topic>Eye Infections, Fungal - diagnosis</topic><topic>Eye Infections, Fungal - drug therapy</topic><topic>Eye Infections, Fungal - microbiology</topic><topic>Female</topic><topic>fungal endophthalmitis</topic><topic>Humans</topic><topic>Lens Implantation, Intraocular</topic><topic>Mycoses - diagnosis</topic><topic>Mycoses - drug therapy</topic><topic>Mycoses - microbiology</topic><topic>Operating Rooms</topic><topic>Paecilomyces</topic><topic>Paecilomyces - isolation & purification</topic><topic>Phacoemulsification</topic><topic>postoperative endophthalmitis</topic><topic>pseudophakic endophthalmitis</topic><topic>Surgical Wound Infection - diagnosis</topic><topic>Surgical Wound Infection - drug therapy</topic><topic>Surgical Wound Infection - microbiology</topic><topic>vitrectomy</topic><topic>Vitreous Body - microbiology</topic><toplevel>online_resources</toplevel><creatorcontrib>Tarkkanen, Ahti</creatorcontrib><creatorcontrib>Raivio, Virpi</creatorcontrib><creatorcontrib>Anttila, Veli‐Jukka</creatorcontrib><creatorcontrib>Tommila, Petri</creatorcontrib><creatorcontrib>Ralli, Reijo</creatorcontrib><creatorcontrib>Merenmies, Lauri</creatorcontrib><creatorcontrib>Immonen, Ilkka</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Acta ophthalmologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tarkkanen, Ahti</au><au>Raivio, Virpi</au><au>Anttila, Veli‐Jukka</au><au>Tommila, Petri</au><au>Ralli, Reijo</au><au>Merenmies, Lauri</au><au>Immonen, Ilkka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fungal endophthalmitis caused by Paecilomyces variotii following cataract surgery: a presumed operating room air‐conditioning system contamination</atitle><jtitle>Acta ophthalmologica Scandinavica</jtitle><addtitle>Acta Ophthalmol Scand</addtitle><date>2004-04</date><risdate>2004</risdate><volume>82</volume><issue>2</issue><spage>232</spage><epage>235</epage><pages>232-235</pages><issn>1395-3907</issn><eissn>1600-0420</eissn><abstract>.
Purpose: To report a case of delayed fungal endophthalmitis by Paecilomyces variotii following uncomplicated cataract surgery. To our knowledge this is the first reported case of postoperative endophthalmitis by this species.
Methods: We report the longterm clinical follow‐up of an 83‐year‐old female who underwent uncomplicated sutureless, small‐incision cataract surgery. She developed recurring uveitis 4 months after surgery. Vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens were performed. Fungi were studied by histopathology and culture.
Results: At histopathological examination, the fungi were found to be closely related with the capsular bag. A few mononuclear inflammatory cells were encountered. At culture, Paecilomyces variotii, a common ubiquitous non‐pathogenic saprophyte, was identified. Despite systemic, intravitreal and topical antifungal therapy after vitrectomy the uveitis recurred several times, but no fungal organisms were isolated from the repeat intraocular specimen. At 18 months postoperatively the subject's visual acuity was finger counting at 2 metres. At the time of surgery the operating room air‐conditioning system was undergoing repairs. Cases of fungal endophthalmitis after contamination from air‐conditioning ventilation systems have been reported before, but none of the cases reported have been caused by P. variotii.
Conclusion: P. variotii, a non‐pathogenic environmental saprophyte, may be disastrous if introduced into the eye. International recommendations on the environmental control of the operating room air‐conditioning ventilation system should be strictly followed. No intraoperative surgery should be undertaken while the air‐conditioning system is undergoing repairs or service.</abstract><cop>Oxford, UK; Malden, USA</cop><pub>Blackwell Science Ltd/Inc</pub><pmid>15043549</pmid><doi>10.1111/j.1600-0420.2004.00235.x</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Aged, 80 and over Air Conditioning Air Microbiology Anti-Bacterial Agents cataract surgery Cross Infection Device Removal Drug Therapy, Combination - therapeutic use Endophthalmitis - diagnosis Endophthalmitis - drug therapy Endophthalmitis - microbiology Equipment Contamination Eye Infections, Fungal - diagnosis Eye Infections, Fungal - drug therapy Eye Infections, Fungal - microbiology Female fungal endophthalmitis Humans Lens Implantation, Intraocular Mycoses - diagnosis Mycoses - drug therapy Mycoses - microbiology Operating Rooms Paecilomyces Paecilomyces - isolation & purification Phacoemulsification postoperative endophthalmitis pseudophakic endophthalmitis Surgical Wound Infection - diagnosis Surgical Wound Infection - drug therapy Surgical Wound Infection - microbiology vitrectomy Vitreous Body - microbiology |
title | Fungal endophthalmitis caused by Paecilomyces variotii following cataract surgery: a presumed operating room air‐conditioning system contamination |
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