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Ocular Candidiasis

HomeIntraocular Inflammation and Uveitis / Endophthalmitis

Title: Ocular Candidiasis

Authors: Christopher D. Conrady, MD, PhD, Rachel Jacoby, MD, Akbar Shakoor, MD, and Paul Bernstein MD, PhD

Date: 11/2016

Keywords/Main Subjects: candidiasis, endophthalmitis, fungal endophthalmitis

Diagnosis/Differential Diagnosis: Presumed Candida endophthalmitis

Brief Description of Case: In the following cases, we present a 13-year-old boy that was being treated for B cell ALL.  He developed a fever of unknown origin and was subsequently found to have GI imaging findings consistent with systemic candida.  Blood cultures remained negative.  Due to concern for candida, ophthalmology was asked to evaluate the patient and he was subsequently found to have two chorioretinal lesions of the left eye.  He was initially closely monitored on IV antifungal therapy but then required intraocular injections, and finally, a pars plana vitrectomy due to re-activation of the lesions.  Unfortunately, no microbiology could help direct therapy in this case and the full case is seen in detail in the presentation.

Images:

Slides 4, 5, 9, 10, 11, 14, and 17 are dilated fundus photographs.   Slide 14 specifically shows the re-activation of the lesion once the patient was transitioned to oral antifungals as seen with the hazy borders and enlarged size compared to prior images.

Slide 21: Denotes a second case of presumed candida fungal endophthalmitis in a 10-year-old boy being treated for ALL.  He has two notable peripheral lesions in the left eye.  Due to their non-central nature, the spots were monitored closely and remained unchanged while on anti-fungal therapy.  His other eye (not shown) had a foveal-involving lesion that required intravitreal antifungal therapy in addition to systemic antifungals.

Summary of Cases:

These two cases highlight the medical and surgical management of fungal endophthalmitis.

References for further reading:

Copyright statement: Christopher D. Conrady, ©2016. For further information regarding the rights to this collection, please visit: URL to copyright information page on Moran CORE

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