An outbreak of Fusarium solani endophthalmitis after cataract surgery in an eye training and research hospital in Istanbul

• Published in: Mycoses 2011-11, Vol.54 (6), p.e767-e774
• Main Authors: Güngel, Hülya, Eren, Mümin Hakan, Pınarcı, Eylem Yaman, Altan, Çiğdem, Baylançiçek, Deniz Oygar, Kara, Necip, Gürsel, Tanıl, Yegenoğlu, Yildiz, Susever, Serdar
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antifungal Agents - administration & dosage; antifungal treatment; Cataract Extraction - adverse effects; Cataracts; Cefuroxime; Cornea; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - pathology; Cross Infection - therapy; Disease Outbreaks; Endophthalmitis; Endophthalmitis - epidemiology; Endophthalmitis - microbiology; Endophthalmitis - pathology; Endophthalmitis - therapy; Eye; Eye Infections, Fungal - epidemiology; Eye Infections, Fungal - microbiology; Eye Infections, Fungal - pathology; Eye Infections, Fungal - therapy; Eye lens; Female; Fusariosis - epidemiology; Fusariosis - microbiology; Fusariosis - pathology; Fusariosis - therapy; Fusarium - genetics; Fusarium - growth & development; Fusarium - isolation & purification; Fusarium solani; Geriatrics; Hospitals; Humans; Infection; Male; Middle Aged; Nucleotide sequence; Prognosis; Risk factors; Surgery; Surgical Wound Infection - epidemiology; Surgical Wound Infection - microbiology; Surgical Wound Infection - pathology; Surgical Wound Infection - therapy; Vitrectomy
• ISSN: 0933-7407; 1439-0507
• DOI: 10.1111/j.1439-0507.2011.02019.x

Summary To report an outbreak of Fusarium solani endophthalmitis after uneventful cataract surgeries performed on the same day in the same operating room. Nine patients underwent phacoemulsification at 4th Clinic of Beyoglu Eye Training and Research Hospital in Istanbul. Cefuroxime axetyl was injected intracamerally from the same vial to all patients at the end of surgery. All patients developed acute postoperative endophthalmitis. Presentation, cultural studies, treatment, clinical responses and risk factors were evaluated. Cultural and DNA sequence findings revealed F. solani. Antifungal therapy was begun and pars plana vitrectomy, intraocular lens and capsule extraction were performed. Corneal involvement was correlated with old age and systemic disease. Fusarium solani should be considered in acute postoperative endophthalmitis. This infection can be controlled with early and aggressive combined antifungal and surgical treatment. The patients with corneal involvement had poor prognosis. It is important to use solutions prepared separately for each patient.