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Case Report: Poor Outcome Despite Aggressive Management in Pythium insidiosum Endophthalmitis

David AggarwalAnant Bajaj Retina Institute, L V Prasad Eye Institute (LVPEI), Hyderabad, India;

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Sanchita MitraJhaveri Microbiology Centre, LVPEI, Hyderabad, India;

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Paavan KalraThe Cornea Institute, LVPEI, Hyderabad, India;

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Bhupesh BaggaThe Cornea Institute, LVPEI, Hyderabad, India;

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Dilip MishraDepartment of Ophthalmic Pathology Laboratory, LVPEI, Hyderabad, India;

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Brijesh TakkarAnant Bajaj Retina Institute, L V Prasad Eye Institute (LVPEI), Hyderabad, India;
Indian Health Outcomes, Public Health, and Economics Research Centre, LVPEI, Hyderabad, India

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ABSTRACT.

Pythium insidiosum is a parasitic oomycete that can cause keratitis and closely resembles fungus, both clinically and morphologically. It requires a trained microbiologist for its differentiation from fungal filaments and has poor response to antifungal therapy. We present a case of primary isolation of the organism from the vitreous cavity in a case of endophthalmitis. The infection spread quickly and involved all the ocular tissues. The eye had poor visual outcome despite a sequence of rapidly completed retinal and corneal surgeries along with initiation of anti-Pythium therapy.

Author Notes

Address correspondence to Brijesh Takkar, L V Prasad Eye Institute, Rd. #2 Banjara Hills, Hyderabad 500 034, India. E-mail: britak.aiims@gmail.com

Financial support: All authors were supported by the Hyderabad Eye Research Foundation, Hyderabad, India. B. T. was supported by a Department of Biotechnology Wellcome Trust India Alliance Clinical Research Centre grant awarded to the IHOPE Centre (grant number IA/CRC/19/1/610010).

Authors’ addresses: David Aggarwal, Anant Bajaj Retina Institute, L V Prasad Eye Institute (LVPEI), Hyderabad, India, E-mail: davidaggarwal@gmail.com. Sanchita Mitra, Jhaveri Microbiology Center, LVPEI, Hyderabad, India, E-mail: sanchita.mitra@lvpei.org. Paavan Kalra and Bhupesh Bagga, The Cornea Institute, LVPEI, Hyderabad, India, E-mails: paavankalra@gmail.com and bhupesh@lvpei.org. Dilip Mishra, Department of Ophthalmic Pathology Laboratory, LVPEI, Hyderabad, India, E-mail: dilipkumarmishra@lvpei.org. Brijesh Takkar, Anant Bajaj Retina Institute, LVPEI, Hyderabad, India, and Indian Health Outcomes, Public Health, and Economics Research Centre, LVPEI, Hyderabad, India, E-mail: britak.aiims@gmail.com.

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