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

Background 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. Methods Case series. Observations 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. Conclusions 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.