CHRONIC BASIDIOMYCETOUS ENDOPHTHALMITIS AFTER EXTRACAPSULAR CATARACT-EXTRACTION AND INTRAOCULAR-LENS IMPLANTATION

Background: Basidiomycetes are known as rare pathogens for meningitis, sinusitis, pneumonia, ulcerative lesions of the hard palate and onych omycosis. To our knowledge, no filamentous basidiomycete has been repo rted from a case of fungal endophthalmitis. Patient: We report on a 67 -year-old man with delayed-onset endophthalmitis caused by an opportun istic basidiomycete. Tissue obtained during vitrectomy was cultured an d examined by light and transmission electron microscopy. After enucle ation the eye was examined by light microscopy. Conclusion: The patien t had endophthalmitis from a sterile hyphomycete, harboured in remnant s of lens capsule and a granuloma on the ciliary body. It was recogniz ed as a Holobasidiomycete on the basis of its dolipore structure with perforated pore cap, seen with transmission electron microscopy. Speci es identification was not possible because fruiting bodies were absent . The patient failed to respond to intravitreal and systemic amphoteri cin B and systemic itraconazole. The eye was enucleated. This case dem onstrates that filamentous basidiomycetes can cause endophthalmitis wh en inoculated during cataract extraction.