First Documented Successful Treatment of Chronic Postoperative Fungal Endophthalmitis Induced by Trichosporon Inkin with Fluconazole

Abstract

Ning Fan,1,* Xuehong Duan,1,* Xuan Liu,2 Ping Fan,1 Ningning Chen,2 Jihong Sun3 1Department of Laboratory Medicine, The First People’s Hospital of Xianyang, Xianyang, People’s Republic of China; 2Department of Ophthalmology, The First People’s Hospital of Xianyang, Xianyang, People’s Republic of China; 3Department of Laboratory Medicine, Xianyang Hospital of Yan’ an University, Xianyang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ping Fan, Department of Laboratory Medicine, The First People’s Hospital of Xianyang, Xianyang, 712000, People’s Republic of China, Email [email protected]: This report details an uncommon occurrence of chronic endophthalmitis following cataract surgery attributed to an infection by Trichosporon inkin (T. inkin). The infection was identified through MALDI-TOF mass spectrometry along with sequencing analysis. Although the patient exhibited a robust immune response, the infection escalated quickly from the right eye to the left. Treatment involved vitrectomy and peeling surgery on the right eye, paired with systemic fluconazole antifungal therapy and intravitreal injection, resulting in significant recovery. The visual acuity of the right eye enhanced from finger counting to 20/63. This account represents the inaugural documented instance of endophthalmitis caused by T. inkin that was effectively managed with fluconazole. This underscores the critical role of vitreous humor enrichment culture and antifungal susceptibility testing of T. inkin in the treatment of endophthalmitis.Keywords: endophthalmitis, Trichosporon inkin, matrix-assisted laser desorption ionization time of flight, MALDI-TOF, fluconazole

Keywords

• endophthalmitis
• trichosporon inkin
• matrix-assisted laser desorption ionization time of flight
• maldi-tof
• fluconazole