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Ochroconis gallopava endophthalmitis in fludarabine treated chronic lymphocytic leukaemia
  1. JEREMY D BOWYER
  1. St Paul's Eye Unit, Royal Liverpool University Hospital, Prescott Street, Liverpool L7 8XP
  2. Public Health Laboratory Service, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL
  3. Department of Haematology and Oncology, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH
  4. Department of Ophthalmology, Queen's Medical Centre, University Hospital, Nottingham NG7 2YH
  1. ELIZABETH M JOHNSON
  1. St Paul's Eye Unit, Royal Liverpool University Hospital, Prescott Street, Liverpool L7 8XP
  2. Public Health Laboratory Service, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL
  3. Department of Haematology and Oncology, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH
  4. Department of Ophthalmology, Queen's Medical Centre, University Hospital, Nottingham NG7 2YH
  1. ELIZABETH H HORN
  1. St Paul's Eye Unit, Royal Liverpool University Hospital, Prescott Street, Liverpool L7 8XP
  2. Public Health Laboratory Service, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL
  3. Department of Haematology and Oncology, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH
  4. Department of Ophthalmology, Queen's Medical Centre, University Hospital, Nottingham NG7 2YH
  1. RICHARD M C GREGSON
  1. St Paul's Eye Unit, Royal Liverpool University Hospital, Prescott Street, Liverpool L7 8XP
  2. Public Health Laboratory Service, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL
  3. Department of Haematology and Oncology, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH
  4. Department of Ophthalmology, Queen's Medical Centre, University Hospital, Nottingham NG7 2YH
  1. Dr Bowyer

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Editor,—Disseminated fungal infection is an important cause of morbidity and mortality in immunocompromised patients, often due to candida and aspergillus species. Endogenous endophthalmitis is a recognised complication.1 We present, to our knowledge, the first reported case of endogenous intraocular infection with the emerging pathogen Ochroconis gallopava, acquired following treatment for chronic lymphocytic leukaemia (CLL).

CASE REPORT

A 69 year old man presented with a 4 day history of painless loss of vision in the left eye after receiving four courses of fludarabine (25 mg/m2 over 5 days) for CLL. Standard infection prophylaxis following myelosuppression included oral fluconazole 50 mg once daily. His neutropenia improved (7.96×109/l) but profound lymphopenia persisted (0.11×109/l).

Visual acuity was right eye 6/6+4 and left eye hand movements. The right eye was normal throughout. Anterior uveitis, hypopyon, lens opacity, and vitritis compromised left funduscopy. A lymphoproliferative or infective aetiology was suspected. Anterior chamber paracentesis …

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