Pseudophakic Penicillium endophthalmitis

A healthy 76-year-old woman complained of redness and a painful sensation in her right eye after cataract surgery 5 months previously. The eye was treated with topical corticosteroid and ciprofloxacin, and a soft exudative mass on the nasal lower iris was noted later. Fungal endophthalmitis was suspected and a repeat aqueous culture grew Penicillium spp. After treatment with topical natamycin and an intracameral injection of amphotericin B, the endophthalmitis was cured. We describe the disease course and management and discuss topical corticosteroids as a possible risk factor for increasing the dissemination of Penicillium infection. This was a unique case of successful therapy resulting in the cure of Penicillium endophthalmitis in an immunocompetent patient.