Korean J Lab Med.  2006 Feb;26(1):36-38. 10.3343/kjlm.2006.26.1.36.

Endogenous Endophthalmitis by Aspergillus in a Patient with Multiple Myeloma

• Park YH
• Kim CK
• Lee H
• Roh KH
• Jung JW
• Yong D
• Lee K

• KMID: 2143195
• DOI: http://doi.org/10.3343/kjlm.2006.26.1.36

Abstract

A 40-year-old man who had been treated for multiple myeloma, complained of decreased visual acuity of the left eye on the 30th day of admission. The nucleotide sequences of a fungal PCR product from vitreous fluid showed 99% homology with Aspergillus fumigatus (AY373851). Aspergillus spp. was isolated from vitreous fluid culture, also. Rapid diagnosis and intervention are critical elements for the Aspergillus endophthalmitis; therefore, it would be helpful to combine the fungal PCR with conventional fungus culture for clinically indicated specimens.

Keyword

Aspergillus; Endophthalmitis; Fungal PCR

MeSH Terms

Adult
Aspergillus fumigatus
Aspergillus*
Base Sequence
Diagnosis
Endophthalmitis*
Fungi
Humans
Multiple Myeloma*
Polymerase Chain Reaction
Visual Acuity

Figure

• 

  Fig. 1. Results obtained after fungal PCR. Lane1, clinical sample (596 bp); lane 2 & 4, positive controls (C. albicans ATCC 90028, 536 bp); lane 3, negative control (S. aureus ATCC 25923); and lane 5, size marker (Takara, Tokyo, Japan).

Reference

References

1. Read RW. Endophthalmitis. Yanoff M, editor. Ophthalmology. 2nd ed.St. Louis: Mosby;2004. p. 1153–8.

2. Essman TF, Flynn HW Jr, Smiddy WE, Brod RD, Murray TG, Davis JL, et al. Treatment outcomes in a 10-year study of endogenous fungal endophthalmitis. Ophthalmic Surg Lasers. 1997; 28:185–94.

3. Binder MI, Chua J, Kaiser PK, Procop GW, Isada CM. Endogenous endophthalmitis: an 18-year review of culture-positive cases at a tertiary care center. Medicine. 2003; 82:97–105.

4. Yeghen T, Kibbler CC, Prentice HG, Berger LA, Wallesby RK, McWhinney PH, et al. Management of invasive pulmonary aspergillosis in hematology patients: a review of 87 consecutive cases at a single institution. Clin Infect Dis. 2000; 31:859–68.

5. Riddell Iv J, McNeil SA, Johnson TM, Bradley SF, Kazanjian PH, Kauffman CA. Endogenous Aspergillus endophthalmitis: report of 3 cases and review of the literature. Medicine. 2002; 81:311–20.

6. Ferrer C, Colom F, Frases S, Mulet E, Abad JL, Alio JL. Detection and identification of fungal pathogens by PCR and by ITS2 and 5.8S ribosomal DNA typing in ocular infections. J Clin Microbiol. 2001; 39:2873–9.

7. Okada AA, Johnson RP, Liles WC, D'Amico DJ, Baker AS. Endogenous bacterial endophthalmitis. Report of a ten-year retrospective study. Ophthalmology. 1994; 101:832–8.

8. Hassan IJ, MacGowan AP, Cook SD. Endophthalmitis at the Bristol Eye Hospital: an 11-year review of 47 patients. J Hosp Infect. 1992; 22:271–8.

9. Shin JH. Laboratory diagnosis of opportunistic fungal infections. Korean J Clin Microbiol. 1998; 1:37–43.

10. Machado D de O, Goncalves R, Fernandes EM, Campos WR Orefice F, Curi AL. Bilateral Aspergillus endophthalmitis in a patient with chronic lymphocytic leukaemia. Br J Ophthalmol. 2003; 87:1429–30.

11. Thomson Jr RB, Miller JM. Specimen collection, transport, and processing: Bacteriology. Murray PR, Baron EJ, Pfaller MA, Jorgensen JH, Yolken RH, editors. eds.Manual of clinical microbiology. 8th ed.Washington, D.C.: ASM Press;2003. p. 286–330.

12. McClenny N. Laboratory detection and identification of Aspergillus species by microscopic observation and culture: the traditional approach. Med Mycol. 2005; 43(S1):):S125–8.

13. Lass-Florl C, Speth C, Mayr A, Wurzner R, Dierich MP, Ulmer H, et al. Diagnosing and monitoring of invasive aspergillosis during antifungal therapy by polymerase chain reaction: an experimental study in mice. Diagn Microbiol Infect Dis. 2003; 47:569–72.

14. Okhravi N, Adamson P, Lightman S. Use of PCR in endophthalmitis. Ocul Immunol Inflamm. 2000; 8:189–200.

15. Jaeger EE, Carroll NM, Choudhury S, Dunlop AA, Towler HM, Matheson MM, et al. Rapid detection and identification of Candida, Aspergillus, and Fusarium species in ocular samples using nested PCR. J Clin Microbiol. 2000; 38:2902–8.