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RETINAL Cases & Brief Reports:
doi: 10.1097/ICB.0000000000000041
Case Report

CHRONIC ENDOPHTHALMITIS DUE TO PYRENOCHETA ROMEROI IN AN IMMUNOCOMPETENT HOST—A CASE REPORT FROM SOUTHERN INDIA

Babu, Kalpana DO, MRCOphth (Lon)*; Murthy, Praveen R. MS*; Prakash, Peralam Y. MSc, PhD; Kattige, Jyoti MS*; Rangaswamy, Sukanya MD; Murthy, Vinay R. MS*; Murthy, Krishna R. DO, MRCOphth (Lon)*

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Abstract

Purpose:

Endophthalmitis due to Pyrenochaeta romeroi has not been reported in literature (PubMed, Medline). We report an interesting case of P. romeroi causing chronic endophthalmitis in an immunocompetent lady.

Methods:

Retrospective interventional case report. A 25-year-old immunocompetent lady presented with pain and redness in the left eye of 1-month duration. Her best-corrected visual acuity was 6/6 and 6/18 in the right and the left eyes, respectively. Slit-lamp examination of the left eye showed a corneal stromal scar, fibrinlike material in the anterior chamber, few retrolental cells, and normal fundus examination.

Results:

Aqueous taps on two occasions were negative for bacteria and fungi on routine smear, culture, and nested polymerase chain reaction. As inflammation recurred despite intravitreal voriconazole and amikacin injections, a lensectomy with vitrectomy was done. During vitrectomy, dense flocculent material was seen in the pars plana with only scleral indentation. The flocculent material grew a rare filamentous fungus called P. romeroi. The left eye underwent retinal detachment surgery with silicone oil insertion for a giant retinal tear at 2 months of follow-up. At 6 months of follow-up, her vision in the left eye was stable at 6/24 (Snellen) with no ocular inflammation.

Conclusion:

P. romeroi may need to be added in the list of rare fungi, which cause chronic endophthalmitis.

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