NDLI: Scedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review

Content Provider	Springer Nature : BioMed Central
Author	Todokoro, Daisuke Hoshino, Junki Yo, Ayaka Makimura, Koichi Hirato, Junko Akiyama, Hideo
Abstract	Background Ubiquitous fungi of the Scedosporium apiospermum species complex (SASC) cause various opportunistic infections. Posterior subtenon triamcinolone acetonide (STTA) injection is a standard therapy for intraocular inflammation and macular edema. We report a case of Scedosporium apiospermum infectious scleritis after a posterior STTA injection. Case presentation A 75-year-old man received a posterior STTA injection to treat macular edema in his left eye. After 3 months, he complained of ocular pain and hyperemia in his left eye. Examination showed a subtenon abscess in the site corresponding with the STTA injection. After incising the abscess, the smear revealed numerous conidia-like structures. Although we suspected fungal infection and started topical voriconazole (VRCZ) and levofloxacin, the inflammation of the eye worsened. Fungal culture revealed filamentous fungus growth. Subsequently, we added systemic VRCZ and performed surgical debridement of the infected sclera and Tenon’s capsule. Pathology of the sclera showed fungal hyphae. The antifungal susceptibility test revealed low minimum inhibitory concentrations for micafungin, VRCZ and miconazole (0.06, 0.25 and 0.5 μg/mL, respectively). After 2 months, the ciliary injection subsided and VRCZ therapy was stopped. However, subtenon abscess recurred 1 month after discontinuation of topical VRCZ. Surgical debridement and topical VRCZ were resumed, with the eye finally improving after 5 months of management. The fungal species was identified as Scedosporium apiospermum sensu stricto morphologically and by DNA sequencing. Conclusions This case was successfully treated by topical and systemic VRCZ and repeated surgical debridement. Infectious scleritis caused by SASC rarely develops after posterior STTA. SASC can produce conidia in the enclosed subtenon space. Late-onset infectious scleritis after a posterior STTA injection suggests the presence of a fungal infection, including SASC, thereby requiring extensive and prolonged medical and surgical treatment.
Related Links	https://bmcophthalmol.biomedcentral.com/counter/pdf/10.1186/s12886-018-0707-4.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14712415
DOI	10.1186/s12886-018-0707-4
Journal	BMC Ophthalmology
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2018-02-13
Access Restriction	Open
Subject Keyword	Ophthalmology Scedosporium apiospermum Posterior subtenon triamcinolone acetonide injection Infectious scleritis Voriconazole
Content Type	Text
Resource Type	Case study
Subject	Ophthalmology
Journal Impact Factor	1.7/2023
5-Year Journal Impact Factor	2/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Orbital abscess caused by Exophiala dermatitidis following posterior subtenon injection of triamcinolone acetonide: a case report and a review of literature related to Exophiala eye infections

Necrotic scleral melt and fungal keratitis—a complication of subtenon triamcinolone acetonide injection

Conjunctival Necrosis and Scleritis Following Subtenon Triamcinolone Acetonide Injection

Scleral abscess following posterior subtenon triamcinolone acetonide injection for diabetic macular edema

Persistent glaucoma secondary to posterior subtenon steroid injection of triamcinolone acetonide (Kenalog®): case reports

Comparison between intravitreal ranibizumab injection and posterior subtenon triamcinolone acetonide injection at time of cataract surgery for prevention of progression of diabetic macular edema

Effect of Posterior Subtenon Triamcinolone Acetonide Injection on Diabetic Macular Edema Refractory to Intravitreal Bevacizumab Injection.

Scedosporium apiospermum EUMYCETOMA SUCCESSFULLY TREATED WITH ORAL VORICONAZOLE: REPORT OF A CASE AND REVIEW OF THE BRAZILIAN REPORTS ON SCEDOSPORIOSIS

Effect of Posterior Subtenon Triamcinolone Acetonide Injection on Diabetic Macular Edema Refractory to Intravitreal Bevacizumab Injection

Scedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review

Similar Documents

Orbital abscess caused by Exophiala dermatitidis following posterior subtenon injection of triamcinolone acetonide: a case report and a review of literature related to Exophiala eye infections

Necrotic scleral melt and fungal keratitis—a complication of subtenon triamcinolone acetonide injection

Conjunctival Necrosis and Scleritis Following Subtenon Triamcinolone Acetonide Injection

Scleral abscess following posterior subtenon triamcinolone acetonide injection for diabetic macular edema

Persistent glaucoma secondary to posterior subtenon steroid injection of triamcinolone acetonide (Kenalog®): case reports

Comparison between intravitreal ranibizumab injection and posterior subtenon triamcinolone acetonide injection at time of cataract surgery for prevention of progression of diabetic macular edema

Effect of Posterior Subtenon Triamcinolone Acetonide Injection on Diabetic Macular Edema Refractory to Intravitreal Bevacizumab Injection.

Scedosporium apiospermum EUMYCETOMA SUCCESSFULLY TREATED WITH ORAL VORICONAZOLE: REPORT OF A CASE AND REVIEW OF THE BRAZILIAN REPORTS ON SCEDOSPORIOSIS

Effect of Posterior Subtenon Triamcinolone Acetonide Injection on Diabetic Macular Edema Refractory to Intravitreal Bevacizumab Injection

Scedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review