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September 1989

Cure of Paecilomyces Endophthalmitis With Multiple Intravitreal Injections of Amphotericin B

Author Affiliations

Sydney, Australia

Arch Ophthalmol. 1989;107(9):1281. doi:10.1001/archopht.1989.01070020351009

To the Editor.  Paecilomyces lilacinus is a highly pathogenic fungus within the eye, and its in vitro sensitivity to amphotericin B is low.1,2 Cure of endophthalmitis due to this organism has been reported after the use of intravitreal antimycotic therapy.1 However, two of three patients with P lilacinus keratitis treated by penetrating keratoplasty developed intractible endophthalmitits postoperatively and failed to respond to multiple vitrectomies and multiple intraocular injections of miconazole.2We report a case of exogenous P lilacinus endophthalmitis that was successfully treated after the third recurrence by 11 intravitreal injections of 10 μg of amphotericin B over 14 days.

Report of a Case.  —A 43-year-old farmer developed fungal keratitis after injuring his right eye. Despite administration of topical natamycin and miconazole, the infection worsened, and a therapeutic penetrating keratoplasty was performed on March 27,1981. Septate fungal hyphae were noted in the deep corneal stroma of

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