Atypical Endogenous Fungal Endophthalmitis Caused by Candida Rugosa

Abstract

Purpose: The purpose of this study was to report a case of atypical endogenous fungal endophthalmitis caused by Candida rugosa, a rare species of nonalbicans Candida. Methods: This report describes a case of a 45-year-old woman who presented with a reduced visual acuity in the right eye in addition to vitreous opacity during breast cancer treatment, which was suspected as fungal endophthalmitis from medical examination and history. Various tests were performed for diagnosis. Results: Blood test results were normal, including the blood beta-D-glucan level, and blood cultures were negative. Diagnosis could not be made using systemic computed tomography and magnetic resonance imaging results. Therefore, a lesion sample was collected by using vitrectomy. C. rugosa was identified through DNA (extracted from the lesion sample) analysis using Basic Local Alignment Search Tool. The visual acuity of the right eye improved after vitrectomy. Conclusion: We encountered a rare case of atypical endogenous fungal endophthalmitis caused by C. rugosa. Clinicians sometimes encounter invasive candidiasis caused by rare nonalbicans Candida species. DNA analysis using Basic Local Alignment Search Tool is effective for diagnosing such cases.