Acute fungal endophthalmitis post cataract surgery is very rare, let alone after 1 day. Have you eliminated the possibility of TASS?
We have reported a culture proven fusarium fungal keratitis with onset as early as 4 days after cataract surgery in a suboptimal setting of operating theatre:.
Fungal Infection in Clear Corneal Incision Wound Leads to Acute Endophthalmitis Post Phacoemulsification: A Case Series
Default answer is NO, as noted above. Any inflammation ONE DAY after cataract surgery is almost always surgical /iatrogenic sterile inflammation, as Dr Luttrull observed. Having said that, if you extend the onset time to include all acute endophthalmitis, I'd say yes, in India at least, we have seen and reported fungal endophthalmitis in the immediate postoperative period, unlike the teachings of EVS study. This is specially true for Nocardia endophthalmitis (Am J Ophthalmol 2005;139:837–846) and camp-based cataract surgery (Indian J Ophthalmol 2003;51:139-45); but even otherwise, in India, we keep fungus in mind in acute postoperative endophthalmitis (Indian J Ophthalmol: 2010;58:297-302). Not on the 1st post-op day, though, worth reiterating.
the incidence of fungal endophthalmitis at day 1 Postsurgical is rare. I have not experienced yet in my practice but who knows.........expections are always there
Fungal contamination will be possible to occured in immunocompromise cases,but this type of infection is silent with clear media specially in candida retinitis that I had a case of kidny transplant that at least near 10 month follow up it have not progresion without any anti fungal treatment.This case if it have acut onset the smear and diagnotic vitrous tap in diagrential diagnosis is detrimental from steril endophthalmitis or low virolence fungal infection.
Even immunocompromised patients would not present endophthalmitis within the first 24 hours from the surgery.
It is not a matter of immune system it's rather a matter of bacterial load and proliferation time needed to reach a symptomatic level, let alone fungal proliferation time - which is much much longer needless to say.
We have never seen fungal endophthalmitis in the last 25 years and more than 50 000 Cataract Procedures on day one . All surgery was done in Berlin, Germany. 24 Hours are a very short time to produce a observable fungal endophthalmitis. That would be my last suggestion on day one.