Delayed-onset, bleb-associated endophthalmitis caused by Lecythophora mutabilis

PURPOSE: To report delayed-onset, bleb-associated en, dophthalmitis caused by Lecythophora mutabilis. DESIGN: Interventional case report. METHODS: Description of an otherwise healthy woman who developed delayed-onset fungal endophthalmitis associated with a preexisting filtering bleb. RESULTS: A 57-year-old woman who underwent trabeculectomy with Mitomycin C in her left eye 8 years earlier presented with a 10-day history of pain and decreased vision in her left eye. She underwent anterior chamber and vitreous taps and injection of intraocular antibiotics. Cultures grew the mold Lecythophora mutabilis. The patient underwent treatment with intraocular and systemic antifungal agents, three pars plana vitrectomies, partial iridectomy, and cryopexy to the bleb and angle structures. Four months after her last treatment, her left eye shows no residual infection, and vision corrects to 20/80. CONCLUSION: Bleb-associated endophthalmitis caused by L. mutabilis is resistant to amphotericin B but responsive to intravitreal and systemic voriconazole together with pars plana vitrectomy, iridectomy, and cryopexy to the bleb and angle structures. (C) 2004 by Elsevier Inc. All rights reserved.