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Endogenous endophthalmitis is a rare but feared infectious ocular complication of injection drug use (IDU). The recent opioid epidemic in the United States threatens to increase the incidence of this disease. We report the first case of endogenous endophthalmitis in the United States caused by the emerging fungal pathogen Rhodotorula in an injection drug user which led to no light perception vision (NLP). Worldwide experience with Rhodotorula endogenous endophthalmitis is limited, but existing cases suggest infection by this particular fungal genus has a grim prognosis.

most commonly selected preferred treatment, many respondents indicated that more evidence was needed to guide treatment choices. 4 The MUTT I result was driven primarily by ulcers caused by Fusarium, which had the worst response to voriconazole. 1 After the results of MUTT I and 2 subsequent trials, 2,3 only a few experts indicated that they would prefer to treat Fusarium keratitis with voriconazole. Limitations of this study include that respondents self-reported practice patterns and it was not possible to validate the survey against actual practice patterns. Respondents may have underreported voriconazole use because of social desirability bias. The decrease in preference for voriconazole over time may indicate that randomized clinical trials led to changes in practice patterns and integration of evidence-based practices into the treatment of fungal keratitis.

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