From: Candida dubliniensis endophthalmitis: five cases over 15 years
Case (reference) | Sex, age | Comorbidities | Site | Referral pathway | Initial visual acuity | Antifungal sensitivity | Antifungal treatment and surgery | Final visual acuity |
---|---|---|---|---|---|---|---|---|
Sedeek, 2008 [4] | M, 38 | Nil | Right eye | Not reported | VA RE - HM, LE - 20/20 | Fluconazole, voriconazole, caspofungin, amphotericin B | Urgent lensectomy/vitrectomy, IVI vancomycin/ceftazidime. IVI/topical amphotericin B, PO voriconazole (no duration) | Not reported |
Pelegrin, 2010 [5] | M, 41 | IVDU, HIV+, hepatitis B and C, fever, neutropenia | Right eye | Presented to eye emergency | VA RE - 20/200, LE - 20/400 | Azoles | Vitrectomy, IVI amphotericin B. Systemic voriconazole then PO fluconazole for 2 months | VA RE - 20/60 |
Espinosa-Heidmann, 2012 [6] | M, 27 | IVDU, onychomycosis | Left eye | Presented to eye clinic | VA LE - 20/400 | Fluconazole and all other agents tested | Toxoplasma treatment. IV fluconazole. Vitrectomy/IVI amphotericin B. PO fluconazole for 6 weeks | VA LE - 20/80 |
Present case 1 | M, 50 | IVDU, hepatitis C | Right eye | Walk-in to eye outpatients | VA RE - CF, LE - 20/20 | Fluconazole, 5-flucytosine, voriconazole, amphotericin B | Empirical IVI amphotericin B. Vitrectomy. 2× IVI amphotericin B. PO voriconazole for 46 days | VA RE - 20/30, LE - 20/16 |
Present case 2 | M, 28 | IVDU | Right eye | Walk-in to eye outpatients | VA RE - 20/200, LE - 20/20 | Fluconazole, 5-flucytosine, voriconazole | Urgent vitrectomy/IVI voriconazole. Empirical systemic voriconazole. 3× IVI amphotericin B. Vitrectomy/buckle/gas. PO fluconazole for 42 days | VA RE - 20/60, LE - 20/20 |
Present case 3 | M, 34 | IVDU, hepatitis C, endocarditis, PICC | Right eye | Inpatient referral | VA RE - HM, LE - 20/60 | Fluconazole, 5-flucytosine, voriconazole | Empirical fluconazole, IVI amphotericin B. 2× IVI amphotericin B. Vitrectomy. PO voriconazole for 35 days. Vitrectomy/buckle/gas | VA RE - HM, LE - 20/20 |
Present case 4 | M, 55 | T2DM, hepatitis C, liver cirrhosis, PICC | Bilateral | Inpatient referral | VA RE - 20/200, LE - 20/200 | Fluconazole, 5-flucytosine, voriconazole, amphotericin B | Empirical fluconazole. Right vitrectomy. 10× IVI voriconazole RE. 4× IVI voriconazole LE. Left vitrectomy. PO fluconazole for 42 days | VA RE - 20/60, LE - 20/60 |
Present case 5 | F, 21 | IVDU, hepatitis C | Left eye | Walk-in to eye outpatients | VA RE - 20/18, LE - 20/200 | Fluconazole, 5-flucytosine, voriconazole, amphotericin B | Empirical voriconazole, IVI amphotericin B. 8× IVI voriconazole. Vitrectomy. PO fluconazole for 36 days | VA RE - 20/16, LE - 20/30 |