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Sub-retinal abscess as presenting feature of endogenous Candida endophthalmitis

BACKGROUND: Sub-retinal abscess as the presenting feature in the setting of endogenous fungal endophthalmitis is extremely infrequent. Immunodeficiency states are major predisposing risk factors. To the best of our knowledge, this is the first case report of Candida sub-retinal abscess as initial pr...

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Autores principales: Zafar, Sidra, Siddiqui, M. A. Rehman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098582/
https://www.ncbi.nlm.nih.gov/pubmed/30119688
http://dx.doi.org/10.1186/s13104-018-3682-1
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author Zafar, Sidra
Siddiqui, M. A. Rehman
author_facet Zafar, Sidra
Siddiqui, M. A. Rehman
author_sort Zafar, Sidra
collection PubMed
description BACKGROUND: Sub-retinal abscess as the presenting feature in the setting of endogenous fungal endophthalmitis is extremely infrequent. Immunodeficiency states are major predisposing risk factors. To the best of our knowledge, this is the first case report of Candida sub-retinal abscess as initial presentation in an immunocompetent patient. CASE PRESENTATION: A 32-year old, generally fit and well, female presented to us with gradually deteriorating vision in her right eye. Visual acuity was counting fingers in the right eye and, 20/30 in the left eye. Right eye fundus examination showed a full thickness, yellowish-white foveal lesion, and significant vitreous haze. Left eye examination was normal. Upon direct questioning, the patient disclosed history of backstreet abortion 3 weeks prior to the onset of her ocular symptoms. She underwent vitreous tap and intravitreal antibiotics (amphotericin B, 5 μg/0.5 ml). Vitreous culture showed profuse growth of Candida albicans. Because her condition was progressively deteriorating, she underwent 25 g vitrectomy plus repeat intravitreal amphotericin B under general anaesthesia. Three weeks post-vitrectomy, vitreous inflammation resolved completely, and the sub-retinal abscess healed with a macular scar formation. Over a follow-up of 4 years, no recurrences were observed. CONCLUSION: Our case highlights the importance of considering Candida albicans infection in the differential diagnosis of sub-retinal abscesses. Although immunocompromised states are traditionally identified as predisposing factors for fungal infections, fungal endogenous endophthalmitis can occur in healthy individuals as well.
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spelling pubmed-60985822018-08-23 Sub-retinal abscess as presenting feature of endogenous Candida endophthalmitis Zafar, Sidra Siddiqui, M. A. Rehman BMC Res Notes Case Report BACKGROUND: Sub-retinal abscess as the presenting feature in the setting of endogenous fungal endophthalmitis is extremely infrequent. Immunodeficiency states are major predisposing risk factors. To the best of our knowledge, this is the first case report of Candida sub-retinal abscess as initial presentation in an immunocompetent patient. CASE PRESENTATION: A 32-year old, generally fit and well, female presented to us with gradually deteriorating vision in her right eye. Visual acuity was counting fingers in the right eye and, 20/30 in the left eye. Right eye fundus examination showed a full thickness, yellowish-white foveal lesion, and significant vitreous haze. Left eye examination was normal. Upon direct questioning, the patient disclosed history of backstreet abortion 3 weeks prior to the onset of her ocular symptoms. She underwent vitreous tap and intravitreal antibiotics (amphotericin B, 5 μg/0.5 ml). Vitreous culture showed profuse growth of Candida albicans. Because her condition was progressively deteriorating, she underwent 25 g vitrectomy plus repeat intravitreal amphotericin B under general anaesthesia. Three weeks post-vitrectomy, vitreous inflammation resolved completely, and the sub-retinal abscess healed with a macular scar formation. Over a follow-up of 4 years, no recurrences were observed. CONCLUSION: Our case highlights the importance of considering Candida albicans infection in the differential diagnosis of sub-retinal abscesses. Although immunocompromised states are traditionally identified as predisposing factors for fungal infections, fungal endogenous endophthalmitis can occur in healthy individuals as well. BioMed Central 2018-08-17 /pmc/articles/PMC6098582/ /pubmed/30119688 http://dx.doi.org/10.1186/s13104-018-3682-1 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Zafar, Sidra
Siddiqui, M. A. Rehman
Sub-retinal abscess as presenting feature of endogenous Candida endophthalmitis
title Sub-retinal abscess as presenting feature of endogenous Candida endophthalmitis
title_full Sub-retinal abscess as presenting feature of endogenous Candida endophthalmitis
title_fullStr Sub-retinal abscess as presenting feature of endogenous Candida endophthalmitis
title_full_unstemmed Sub-retinal abscess as presenting feature of endogenous Candida endophthalmitis
title_short Sub-retinal abscess as presenting feature of endogenous Candida endophthalmitis
title_sort sub-retinal abscess as presenting feature of endogenous candida endophthalmitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098582/
https://www.ncbi.nlm.nih.gov/pubmed/30119688
http://dx.doi.org/10.1186/s13104-018-3682-1
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