Bilateral endogenous fungal endophthalmitis following elective surgical abortion: a single center case series

TL;DR

Three women developed eye infections after a surgical abortion, and they all improved with antifungal treatment.

Contribution

This is the first reported cluster of fungal eye infections following surgical abortion.

Findings

All three patients showed similar eye lesions and improved with antifungal therapy.

Prompt treatment led to improved vision in all affected eyes.

The cases highlight the need for better sterilization in outpatient surgical settings.

Abstract

To describe the clinical features and management of three cases of bilateral endogenous fungal endophthalmitis following elective surgical abortion performed at the same outpatient surgical center.

Case series.

Three immunocompetent women presented with vision loss days to weeks following elective surgical abortions performed at a single outpatient clinic. Initial visual acuities ranged from 20/20 to 20/300. Fundoscopic examination revealed multiple white round chorioretinal lesions with vitreous infiltration bilaterally in all three patients. Vitreous tap samples were obtained for culture and broad-spectrum intravitreal antimicrobials were administered. Despite negative cultures and systemic workup, the clinical presentation was consistent with fungal endophthalmitis. All patients received systemic and intravitreal antifungal therapy, leading to gradual resolution of lesions and improvement of visual acuity to 20/25 or better in all eyes.

This cases series represents the first reported cluster of endogenous fungal endophthalmitis following surgical abortion. Prompt recognition and treatment with intravitreal and systemic antifungals can result in favorable outcomes. The findings highlight the importance of stringent sterilization protocols in outpatient surgical settings and the need for heighted clinical suspicion in similar presentations.

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