ENDOGENOUS FUSARIUM ENDOPHTHALMITIS IN A PATIENT WITH ACUTE LYMPHOCYTIC-LEUKEMIA

Endogenous fungal endophthalmitis is an uncommon complication of syste mic mycosis. Only a few cases involving Fusarium have been reported, m ost with unfavorable visual outcomes. We examined a 31-year-old woman with acute lymphocytic leukemia who developed sudden visual loss in he r right eye. A dense, white placoid infiltrate was present in the righ t macula extending into the vitreous. An iris nodule and hypopyon were present in the left eye. A vitreous aspirate of the right eye was pos itive for Fusarium species. The patient progressively lost vision desp ite amphotericin B and 5-fluorocytosine therapy. She died from broncho pneumonia, fungemia, and multisystem failure. Histopathologic study di sclosed a panophthalmitis with Fusarium organisms invading all the ocu lar coats in the right eye, Leukemic infiltrates were present in the l eft iris, anterior chamber, and trabecular meshwork. The ocular destru ctiveness of Fusarium may be caused by marked mycotic vascular invasio n and occlusion with consequent infarction and necrosis of ocular tiss ues.