Fusarium solani Endophthalmitis in the Absence of Identifiable Risk Factors: A Case Report and Literature Review

Background: endophthalmitis, enucleation rates exceed 20%. Mortality in disseminated infections among immunocompromised hosts approaches 50-80%, reaching nearly 100% in persistently neutropenic patients. Even among patients who retain the eye, significant visual impairment is nearly universal. To our knowledge, cases arising spontaneously in immunocompetent individuals without any identifiable risk factors have not been previously documented. Case: by ITS and TEF-1α sequencing. Antifungal susceptibility testing showed MICs of 1 μg/mL for both amphotericin B and voriconazole, values well within the wild-type range. Despite guideline-adherent combination therapy (amphotericin B and voriconazole) and early vitrectomy, the infection progressed relentlessly and ultimately necessitating evisceration. Conclusion: endophthalmitis. It also highlights the importance of considering filamentous fungi in the differential diagnosis of unexplained intraocular infections, even in patients without classical risk factors.