Fungal Endophthalmitis Secondary to Aspergillus terreus Exacerbated by Intravitreal Dexamethasone in a Patient With Sarcoidosis

Abstract

Purpose: To report a case of Aspergillus terreus endophthalmitis associated with systemic immunosuppression and an intraocular steroid implant in a patient with sarcoidosis. Methods: A case report was evaluated and a literature review performed. Results: A patient with a history of pulmonary and ocular sarcoidosis presented with new-onset uveitis and was treated for presumed sarcoid flare with oral prednisone and an intravitreal dexamethasone implant before developing worsening vision. She was ultimately diagnosed with A terreus endophthalmitis. Despite both systemic and local antifungals, the visual acuity at the most recent follow-up was no light perception without pain or active inflammation. No definitive source of the fungal disease had been identified. Conclusions: Endophthalmitis resulting from A terreus is associated with poor outcomes. Given the ability of fungal endophthalmitis to mimic other causes of uveitis, one must maintain a high suspicion in patients with any degree of immunosuppression.