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TitleOral Voriconazole in endogenous Scedosporium apiospermum endophthalmitis
Abstract Nr.P10
PurposeTo report the effectiviness of oral voriconazole in a case of endogenous endophtalmitis due to a rare fungus.
MethodsInterventional case report : A 26 year-old woman suffering from mucoviscidosis underwent bipulmonar transplantation in the presence of bronchial colonisation with Scedosporium apiospermum (ScA). Four weeks later, she developped systemic infection due to ScA despite antifungal prophylaxis (itraconazole and amphotericin B). Endogenous fungal endophtalmitis was diagnosed soon after in both eyes.
ResultsDiagnostic vitrectomy was able to demonstrate the causative fungus and a good intravitreal concentration of oral Voriconazole. The drug was able to manage the ophtalmic infection, but had only fungistatic and not fungicidal effect, since systemic infection relapsed 2 days after discontinuating therapy.
ConclusionOral Voriconazole may represent an alternative management of fungal endophthalmitis with less retinal toxicity than intravitreal amphotericin B injection. High ocular bioavailibility on oral administration, good tolerance, and broad spectrum with a low IC 90 make it an interesting option in the management of fungal endophthalmitis in general, and in particular due to ScA which is known to be resistant to many other drugs.
Author 1
Last nameKLEIN
InitialsA
DepartmentUniversité Libre de Bruxelles, Hôpital Erasme
CityBruxelles
Author 2
Last nameSevilla
InitialsE
DepartmentUniversité Libre de Bruxelles, Hôpital Erasme
CityBruxelles
Author 3
Last nameSchrooyen
InitialsM
DepartmentUniversité Libre de Bruxelles, Hôpital Erasme
CityBruxelles
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