The Disease Course of Bilateral Endogenous Fungal Endophthalmitis

Abstract

Purpose: To report the dynamic disease course of a case of bilateral endogenous fungal endophthalmitis, which was successfully treated.Case Report: A 54 year old Chinese man with a history of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy was referred to our center. After 1 week, his best corrected Snellen visual acuity (BCVA) values were 20/100 and 20/25; the interface between the posterior vitreous face and the retinal surface appeared to be rough in the right eye, and a similar, larger, low-rounded circumscribed apophysis could be observed in the left eye. During the 2 nd week, his BCVA values decreased to 20/400 and 20/32. He was diagnosed with bilateral endogenous Candida albicans endophthalmitis after a vitreous biopsy and then underwent binocular pars plana vitrectomy (PPV) with silicone oil injection in both eyes. Postoperatively, his BCVA values were 20/63 and 20/32, and fundoscopy and optical coherence tomography (OCT) showed a regular and smooth interface and retina surface after the removal of the silicone oil at 3 months. Conclusions:We concluded that the rough interface between the posterior vitreous face and the retinal surface is one of the early typical sign of endogenous fungal endophthalmitis, which was treated with PPV with silicone oil injection and antifungal reagents.

Endogenous<i> Candida</i> Endophthalmitis as a Rare Complication of Trans-Urethral Lithotripsy in a Healthy Woman: A Case Report

“…11 In 4 cases, preoperative urine culture was positive for C. albicans and the patients suffered from debilitating diseases (liver cirrhosis, rheumatic arthritis, alcoholic liver disease, or diabetes mellitus). 8,9,10,11 In our case, ECE occurred in an immunocompetent woman after TUL double-J stent placement while pre- and postoperative urine and blood cultures were negative and there were no underlying risk factors.…”

“…6 We found 5 case reports of ECE following urinary tract lithotripsy in our literature review. 7,8,9,10,11 In 3 cases, ECE occurred after ESWL and uretroscopy for double-J stent placement. 7,8,9 In one case, ECE occurred following TUL and ureteral stent placement 10 and in the last case report it occurred after decompressive nephrostomy.…”

“…7,8,9,10,11 In 3 cases, ECE occurred after ESWL and uretroscopy for double-J stent placement. 7,8,9 In one case, ECE occurred following TUL and ureteral stent placement 10 and in the last case report it occurred after decompressive nephrostomy. 11 In 4 cases, preoperative urine culture was positive for C. albicans and the patients suffered from debilitating diseases (liver cirrhosis, rheumatic arthritis, alcoholic liver disease, or diabetes mellitus).…”

Unilateral endogenous Candida endophthalmitis after extracorporeal shock wave lithotripsy for a renal stone in an immunocompetent woman: a case report

“…Extracorporeal shock wave lithotripsy is a noninvasive modality that is wildly used for the treatment of some renal and ureteral stones. Predisposing conditions that have been reported for infectious complications of ESWL include pre-existing UTI; struvite and infected calculi; multiple, large (> 2 cm), and stag-horn stones; urinary tract anatomical abnormality; urinary obstruction; instrumentation; and stent-catheter in the kidney and urinary tracts [6–11]. In our case, ECE occurred as a complication of ESWL in a healthy young woman with no underlying factor.…”

“…The prognosis of visual acuity in endogenous fungal endophthalmitis depended on the location of fungal involvement (central or peripheral) and aggregation, timely diagnosis, type of organisms, and severity of ocular involvement. It also depends on structural changes of the involved area such as scar formation, tractional fibrotic membrane, and retinal detachment [1–3, 6]. In this case report, the patient’s healthy immune system, rapid diagnosis, and timely initiation of antifungal agents promoted a good visual prognosis.…”