Candida endophthalmitis: an unusual complication of prolonged intravenous access

Abstract

A 16 year old boy awaiting a defunctioning colostomy for Crohn's disease complained of reduced vision in his left eye. Four weeks previously candida had been isolated from his central line used for parenteral feeds. Fundal examination of the left eye revealed a macular abscess with a classic "string of pearls" appearance of multiple vitreous abscesses. This was treated with pars plana vitrectomy and intravitreal antifungal therapy. Microbiological studies confirmed a diagnosis of candida endophthalmitis. (Postgrad Med J 2001;77:119-120)

Successful management of presumed Candida endogenous endophthalmitis with oral voriconazole

“…[13] Chronic diseases such as diabetes mellitus and renal insufficiency also increase the risk. In this case, the patient, a chronic diabetic, had been on long-term dialysis and was on oral prednisolone.…”

“…[1] Though microbiologic evidence of the organism causing endophthalmitis is lacking in this case, the typical presentation and the response to therapy with voriconazole, give compelling evidence to an endogenous fungal endophthalmitis due to Candida species.…”

“…The clinical picture was typical of endogenous endophthalmitis in the right eye most probably due to Candida species . [ 1 ] Fundus evaluation of the left eye showed an old branch retinal vein occlusion with photocoagulation scars and changes suggestive of mild non-proliferative diabetic retinopathy.…”

“…Patients with chronic diseases such as diabetes mellitus and renal insufficiency are at the risk of developing endogenous fungal endophthalmitis. [ 1 ] Intravenous and intravitreal voriconazole, a new triazole antifungal agent has been used to treat fungal endophthalmitis. [ 2 ] We report a case of presumed endogenous endophthalmitis in a patient who was on regular hemodialysis for renal insufficiency and compromised systemic status treated successfully only with oral voriconazole.…”

Seeing a cause for blindness in severe pancreatitis

“…This condition has a number of associations, including immunocompromise, prolonged intravenous access or drug abuse, and is a sight threatening disease 1. We believe this is the first case report of a fungal endophthalmitis secondary to translocation from an infected pancreatic fluid collection (PFC).…”