Hospital construction-associated outbreak of ocular aspergillosis after cataract surgery

Objective: This study aimed to report an outbreak of Aspergillus endophthalmitis after cataract extraction during hospital construction. Design: The study design is a case series of an outbreak of Aspergillus endophthalmitis. Participants: Five patients in whom Aspergillus endophthalmitis developed during a period of hospital construction in Jeddah, Saudi Arabia, participated. Severe postoperative uveitis occurred in all five patients and failed to subside with topical steroid therapy. The patients were referred to the King Khaled Eye Specialist Hospital for treatment. The causative organism was identified as Aspergillus fumigatus in each case. Intervention: All five patients were subjected to aqueous or vitreous tap. Three patients had vitrectomy. Patients were given systemic, periocular, and intravitreous antifungal agents. Main Outcome: The final outcome in each patient was evisceration or enucleation, despite an intensive course of antifungal therapy. Results: There were five patients, three females and two males, ranging in age from 51 to 65 years. Postoperative signs of infection developed in the patients 4 to 15 days after surgery. In all five cases, cultures of aqueous or vitreous grew A. fumigatus. Conclusion: Aspergillus endophthalmitis is a serious and devastating complication of ocular surgery. The outbreak, herewith, may have been related to hospital construction. The infection can be prevented, notably, by proper maintenance of old, 'sick' buildings and by following certain procedures during hospital construction.