Candida glabrata endophthalmitis following penetrating keratoplasty

Abstract

We report a case of Candida glabrata endophthalmitis following penetrating keratoplasty in a 57-year-old man. The infection was thought to be treated successfully with intravitreal amphotericin B but flared 7 months later following cataract extraction and eventually required explantation of the intraocular lens and therapeutic keratoplasty. The literature regarding this rare infection is reviewed. Candida glabrata, an uncommon ocular pathogen, is being reported with increasing frequency and with a notable predilection for post-keratoplasty eyes. In the 10 reported cases, there is 100% concordance between host and donor tissue cultures. In half the cases, there was a latent period of several months. These infections can be difficult to treat because C glabrata is often resistant to the antifungal agents commonly used to treat Candida albicans.

Severe donor-related Candida keratitis after Descemet’s stripping automated endothelial keratoplasty

“…Fungal infection following penetrating keratoplasty has a reported incidence rate of 0.16% [1,2]. The recent increase in Descemet's stripping automated endothelial keratoplasty (DSAEK) has been accompanied by an increase in postoperative fungal infection, and five cases have been reported [3][4][5][6].…”

Eye Banking and Corneal Transplantation Communicable Adverse Incidents

“…43 One patient, however, had multiple medical complications, and his immunocompromised status may have contributed to the growth of the organism. Caldwell et al 44 suggest that although C. glabrata endophthalmitis is relatively rare, there seems to be increasing number of reported cases postkeratoplasty. 45,46 There was a 100% concordance between host and donor tissue cultures in 10 reported cases.…”

Donor-Derived Fungal Infections in Transplant Patients

“…Most Candida infections in transplant patients are due to nosocomial infection in the posttransplantation period, but transmission of Candida species via corneal transplantation is a wellrecognized complication [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Fungal colonization of corneal transplants appears to be a combination of both donor-derived infection and contamination during organ harvesting and storage [49].…”