Candida dubliniensis endophthalmitis: first case in North America

Abstract

To report an unusual case of endogenous fungal endophthalmitis due to Candida dubliniensis. Interventional case report of a 27-year-old immunocompetent male with loss of vision, dense vitritis, and chorioretinal infiltrates, who underwent a diagnostic pars plana vitrectomy. Microbiology cultures obtained by a diagnostic vitrectomy were positive for the growth of C. dubliniensis. This infectious process was then appropriately treated with intravitreal amphotericin B and systemic fluconazole with resolution of the endophthalmitis. Endogenous fungal endophthalmitis is a condition that can masquerade other more common causes of endophthalmitis. Atypical cases of endophthalmitis may benefit from diagnostic pars plana vitrectomy for prompt diagnosis and treatment.

The first case of Candida dubliniensis endophthalmitis in North America

“…The case is indeed very rare, but it is important to mention that this should not be considered the first case report in North America [1]. The present case is a ''27-year-old immunocompetent male with loss of vision, dense vitritis, and chorioretinal infiltrates'' [1].…”

“…The present case is a ''27-year-old immunocompetent male with loss of vision, dense vitritis, and chorioretinal infiltrates'' [1]. There is no doubt that this rare infection should be kept in mind by the ophthalmologist.…”

“…Sir, the recent publication on the first case of Candida dubliniensis endophthalmitis in North America is very interesting [1].…”

Third case of Candida dubliniensis endogenous endophthalmitis in North America: case report and review of the literature

“…This case was initially thought to represent the first case of C. dubliniensis endophthlamitis in North America, but a letter to the editor sent by Wiwanitkit revealed that the first case was indeed the one discussed above, rendering the case by Espinosa-Heidmann et al second on the list [20]. This case concerned a 27-year-old white male with a history of intravenous drug use as his only risk factor, and onychomycosis as the suspected source of infection [16].…”

“…The first reports of fungemia from C. dubliniensis were in patients with leukemia, HIV, or end-stage liver disease. The most common risk factors are intravenous drug abuse, HIV infection, bone marrow and solid organ transplantation, and neutropenia resulting from chemotherapy [16,17]. It is also a reported cause of catheter-related fungemia.…”