Case Report Fusarium Endophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole Paulo A. Alves da Costa Pertuiset 1 and Juan F. Batlle Logroño 2 1 Department of Ophthalmology, Cl´ ınica Santa Mar´ ıa, Avenida Santa Mar´ ıa 500, Providencia, 7520378 Santiago, Chile 2 Department of Cornea and Refractive Surgery, Centro Laser, C/Fantino Falco 3, Naco, 10122 Santo Domingo, Dominican Republic Correspondence should be addressed to Paulo A. Alves da Costa Pertuiset; doctor@alvesdacosta.cl Received 22 April 2016; Accepted 29 May 2016 Academic Editor: Stephen G. Schwartz Copyright © 2016 P. A. Alves da Costa Pertuiset and J. F. B. Logro˜ no. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To report a case of postoperative endophthalmitis caused by Fusarium species successfully treated with intravitreal and systemic voriconazole afer treatment failure with amphotericin B. Methods. Clinical case report of a 60-year-old immunocompetent woman who presents with endophthalmitis of unknown origin 4 weeks afer uneventful cataract extraction and IOL implantation surgery. IOL explantation, vitrectomy with capsular bag removal, vitreous aspiration for culture, and intravitreal injection of amphotericin B (5 g/0.1mL) were performed. Diagnosis was established by culturing the vitreous aspirate on a Sabouraud agar medium and staining with lactophenol blue solution. Five days later, there was no clinical response. Te decision was made to administer a single dose of intravitreal voriconazole (2.5 g/0.1 mL) and oral voriconazole (200 mg BID) for 30 days. Results. Fusarium sp. grew on culture. Treatment with local and systemic voriconazole was started afer no improvement with vitrectomy, IOL explantation, and intravitreal amphotericin B. Afer 1 month of treatment, the infection resolved and best-corrected visual acuity was 20/25. Conclusion. In patients with endophthalmitis caused by Fusarium sp., topical and systemic voriconazole treatment should be considered in cases resistant to intravitreal amphotericin B. 1. Introduction Mold endophthalmitis is usually exogenous, is rare afer eye surgery, and has an onset of symptoms occurring two or more months afer surgery [1]. In tropical regions, postcataract fungal endophthalmitis may present more acutely, usually within four weeks of surgery [2]. Fungal species inoculate the aqueous and then they progress posteriorly, involving the vit- reous. Many cases in the literature have occurred in outbreaks [3]. Painful decreased vision with redness and hypopyon are common at presentation. To establish the diagnosis, vitreous samples should be obtained for culture. Amphotericin B is the most commonly recommended antifungal agent [1]. 2. Case Report Tis case involves a 60-year-old housewife with unremark- able systemic medical history and ocular history of an uneventful phacoemulsifcation in her lef eye one year ago. On examination, the Snellen best-corrected visual acuity (BCVA) in both eyes was 20/20 with a manifest refrac- tion of +1.00 SPH in the right eye and −0.25 SPH in the lef eye. She had a mild nuclear sclerotic cataract in her right eye and a posterior chamber intraocular lens (IOL) implanted within the capsular bag in her lef eye. Anterior segment examination in each eye was otherwise unremark- able. Intraocular pressure and fundus examination were normal. Routine preoperative complete blood count (CBC) was normal. She underwent uneventful cataract extraction surgery with intraocular lens (Alcon AcrySof IQ SN60WF) implantation on her right eye, achieving a best-corrected Snellen visual acuity of 20/20 at the 2nd postoperative week. No intracameral antibiotic injection was performed during the surgery. A fxed combination of topical 0.3% gatifoxacin and 1% prednisolone drops was prescribed 5 times a day for Hindawi Publishing Corporation Case Reports in Ophthalmological Medicine Volume 2016, Article ID 4593042, 4 pages http://dx.doi.org/10.1155/2016/4593042