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. 2024 Mar 22;14(1):13.
doi: 10.1186/s12348-024-00393-2.

A case of Lomentospora prolificans endophthalmitis treated with the novel antifungal agent Olorofim

Michael Dong  1 , Fiona Pearce  2   3 , Nandini Singh  2   3 , Ming-Lee Lin  2   3
Affiliations

A case of Lomentospora prolificans endophthalmitis treated with the novel antifungal agent Olorofim

Michael Dong et al. J Ophthalmic Inflamm Infect. .

Abstract

Purpose: To report a case of endogenous Lomentospora prolificans endophthalmitis treated with the novel antifungal agent Olorofim.

Case report: A 57-year-old man developed disseminated Lomentospora prolificans with right endophthalmitis on the background of immunosuppression following lung transplantation for interstitial lung disease. He was treated with early vitrectomy, intravitreal voriconazole, and systemic Olorofim, voriconazole and terbinafine. His symptoms improved and remained stable in the right eye. Eight weeks later the patient represented with Lomentopora prolificans endophthalmitis in the left eye when systemic voriconazole and terbinafine treatment were withdrawn. Despite aggressive treatment he ultimately succumbed due to vascular complications of extensive disseminated disease.

Conclusion: We report a rare case of disseminated Lomentosporosis with panophthalmitis in an immunocompromised host with prolonged survival on systemic Olorofim, voriconazole and terbinafine in conjunction with pars plana vitrectomy and intravitreal voriconazole. Early suspicion of an opportunistic fungal infection is critical, as managing disseminated disease is often unsuccessful. Despite presumed inherent resistance, intravitreal and systemic voriconazole appeared to limit disease progression in the right eye. The potential synergistic effects of combined antifungal therapy with orotomides warrant further investigation.

Keywords: Fungal endophthalmitis; Lomentospora prolificans; Olorofim.

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Conflict of interest statement

The authors report there are no competing interests to declare.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
a Coronal computerised tomography scan of the orbit demonstrating circumferential thickening and enhancement around the entire right globe, vitreous haemorrhage, proptosis and retro-orbital intraconal inflammatory stranding. Normal CT appearance of the left globe. B Intraoperative right fundus photo of the right eye demonstrating large temporal retinal detachment, vitreous haemorrhage, superior area of retinitis and subretinal abscess extending inside superior arcade into macula. C Serial Fludeoxyglucose (FDG) positron emission tomography (PET) scans demonstrating FDG uptake and inflammatory changes in the right globe and subsequent interval improvement in right globe avidity. Images were obtained at approximately 1 month intervals from initial presentation
See this image and copyright information in PMC

References

    1. Pellon A, Ramirez-Garcia A, Buldain I, Antoran A, Martin-Souto L, Rementeria A, et al. Pathobiology of Lomentospora prolificans: could this species serve as a model of primary antifungal resistance? Int J Antimicrob Agents. 2018;51(1):10–5. doi: 10.1016/j.ijantimicag.2017.06.009. - DOI - PubMed
    1. Konsoula A, Tsioutis C, Markaki I, Papadakis M, Agouridis AP, Spernovasilis N. Lomentospora prolificans: an emerging opportunistic fungal pathogen. Microorganisms. 2022;10(7):1317. doi: 10.3390/microorganisms10071317. - DOI - PMC - PubMed
    1. Heath CH, Slavin MA, Sorrell TC, Handke R, Harun A, Phillips M, et al. Population-based surveillance for scedosporiosis in Australia: epidemiology, disease manifestations and emergence of Scedosporium aurantiacum infection. Clin Microbiol Infect. 2009;15(7):689–93. doi: 10.1111/j.1469-0691.2009.02802.x. - DOI - PubMed
    1. Rodriguez-Tudela JL, Berenguer J, Guarro J, Kantarcioglu AS, Horre R, De SybrenHoog G, et al. Epidemiology and outcome of Scedosporium prolificans infection, a review of 162 cases. Sabouraudia. 2009;47(4):359–70. doi: 10.1080/13693780802524506. - DOI - PubMed
    1. Neoh CF, Chen SCA, Crowe A, Hamilton K, Nguyen QA, Marriott D et al (2023) Invasive Scedosporium and Lomentospora prolificans Infections in Australia: A Multicenter Retrospective Cohort Study. Open Forum Infect Dis 10(2) - PMC - PubMed

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