J Korean Ophthalmol Soc.  2010 Dec;51(12):1671-1675.

Cerebral Basilar Artery Mycotic Aneurysm Associated With Aspergillus Endogenous Endophthalmitis

• Lee MY
• Whang WJ
• Lee WK

Abstract

PURPOSE
To report a case of mycotic aneurysm of the cerebral basilar artery associated with bilateral endogenous aspergillus endophthalmitis.
CASE SUMMARY
A 41-year-old man with no underlying disease presented with decreased vision in both eyes. The patient was diagnosed with bilateral endogenous endophthalmitis, and the authors performed a vitrectomy and lensectomy on the right eye. Hyphae were detected in the vitreous sample, and systemic amphotericin was administered. Three days after the operation, the patient became comatose due to a subarachnoid hemorrhage. Aspergillus antigen was detected in the vitreous sample and in the cerebrospinal fluid. Subarachnoid hemorrhage was due to the rupture of a mycotic aneurysm of the cranial basilar artery, complicated by aspergillus infection of the central nervous system.

Keyword

Aspergillus endophthalmitis; Endogenous endophthalmitis; Mycotic aneurysm

MeSH Terms

Adult
Amphotericin B
Aneurysm, Infected
Aspergillus
Basilar Artery
Central Nervous System
Coma
Endophthalmitis
Eye
Humans
Hyphae
Rupture
Subarachnoid Hemorrhage
Vision, Ocular
Vitrectomy
Amphotericin B

Figure

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  Figure 1. Fundus photograph of right eye (A), and left eye (B) at the initial visit. Bilateral severe iniflammation with massive yellowish abscess is found.

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  Figure 2. The ultrasonographic findings of right eye (A), and left eye (B) at the initial visit. Increased vitreous reflectivity due to inflammatory reaction is found in both eye.

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  Figure 3. Brain CT shows aneurysm of the Basilar Artery with irregular arterial surface (arrow).

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  Figure 4. KOH smear of cerebrospinal fluid shows fungal hyphae.

Reference

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