Endogenous Aspergillus-induced endophthalmitis. Successful treatment without systemic antifungal medication.

A 32-year-old man had unilateral visual loss, a gravitational layering of preretinal inflammatory cells in the macula (pseudohypopyon), subretinal infiltrates, and hemorrhagic vasculitis. The patient initially denied intravenous drug abuse. Apsergillus terreus was cultured from undiluted vitreous obtained from a diagnostic and therapeutic vitrectomy specimen. Intravitreal and subconjunctival injections of amphotericin B alone were successful treatment. To the author's knowledge, antemortem diagnosis and treatment of A. terreus-induced endophthalmitis has not been reported previously. This article describes the second case of aspergillar endophthalmitis successfully treated without adjunctive systemic antifungal therapy.