Endogenous Candida albicans infection causing subretinal abscess

Kaburaki, Toshikatsu; Takamoto, Masao; Araki, Fumiyuki; Fujino, Yujiro; Nagahara, Miyuki; Kawashima, Hidetoshi; Numaga, Jiro

doi:10.1007/s10792-009-9304-0

Cited by 19 publications

(20 citation statements)

References 16 publications

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“…As Eddie W. Harris and associates demonstrated, retinectomy with complete abscess excision and intravitreal antibiotic therapy could acquire relatively better visual recovery in EE [1]. Yet, the risk of retinal detachment after retinectomy and drainage of subretinal abscess was high [1–3], surgery for retinal detachment in these cases was difficult, and there was a need for long-term tamponade in such patients post vitrectomy [4]. Tsai TH and Peng KLconsidered that if the size of the subretinal abscess was smaller than four disc areas, PPV with intravitreal injection of antibiotics could be successful.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of endogenous endophthalmitis with extensive subretinal abscess: a case report

et al. 2018

BMC Ophthalmol

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BackgroundEndogenous endophthalmitis could lead to a devastating outcome without a prompt and appropriate management. We report a case of advanced endogenous Klebsiella pneumoniae endophthalmitis with extensive subretinal abscess that was successfully treated with a vitrectomy.Case presentationA systemically well 61-year-old man complained of ocular pain and visual decrease in his right eye for eighteen days. Ophthalmic examination showed dense inflammation in the anterior chamber and vitreous body. Systemic investigations discovered diabetes and no specific site of systemic infection was found after hospitalization. The inflammation continued to worsen after the intravitreal antibiotic injection. Therefore, a pars plana vitrectomy combined with phacoemulsification was performed. Intraoperatively, a white elevated, fluffy mass with the overlying retinal whitening and necrosis was revealed in superior periphery. In addition to this, extensive retinal hemorrhages and five adjacent subretinal whitish masses with exudative retinal detachment were observed in the posterior pole and inferior quadrants, which were suggestive of extensive subretinal abscess with intense overlying retinal inflammation. The excision of white fluffy mass superiorly was performed without retinotomy and aspiration of extensive subretinal abscess. The polymerase chain reaction of vitreous samples was positive for Klebsiella pneumonia. Intravitreal 2 mg/0.1 ml ceftazidime were repeated. Nine days after the surgery, the inflammation significantly subsided and the retina reattached. The patient was in a stable condition at subsequent visit eight months later.ConclusionThe delay in an accurate diagnosis and treatment caused extensive subretinal abscess combined with endogenous endophthalmitis. The treatment modality of subretinal abscess is typically individualized to the patient’s presentation. If the retina overlying the abscess is not necrotic, the extensive subretinal abscess can quickly absorbed after vitrectomy, retinotomy with aspiration of the abscess should be avoided to decrease the risk of retinal detachment.

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Section: Discussionmentioning

confidence: 99%

Successful treatment of endogenous endophthalmitis with extensive subretinal abscess: a case report

et al. 2018

BMC Ophthalmol

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“…As a result, most reported subretinal abscess cases eventually required surgical intervention due to poorly controlled ocular infection 9–12 14–16. Yet, the risk of retinal detachment after drainage of a subretinal abscess is high,9 14 15 18 especially when the effect of silicone oil tamponade is reduced while the abscess resolves and the vitreous cavity volume expands. The dose of intravitreal antibiotics may also have to be adjusted postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Endogenous endophthalmitis with a visual acuity of 6/6

Siu

Lo²,

Young

2015

BMJ Case Reports

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A 43-year-old man suffering fromKlebsiellaliver abscess and bacteraemia presented with left eye visual disturbance a few days after admission. His visual acuity was 6/6. There was a whitish subretinal mass located at the temporal periphery without vitritis. His visual acuity dropped to 6/120 with marked vitritis 1 day later and a diagnosis of a subretinal abscess was made. The vitreous cultures were negative. Response was suboptimal with intravitreal antibiotics, and retinotomy, vitrectomy, antibiotic irrigation and silicone oil tamponade were required. His vision gradually improved to 6/60 with silicone oil in situ. This case illustrates the rare presentation of a subretinal abscess in endogenous endophthalmitis with no initial associated vitritis, and the importance of maintaining a high level of suspicion despite good visual acuity on presentation in cases with relevant history. Early detection and intervention, and close monitoring may salvage the patient's vision in such cases.

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“…44 The initial misdiagno sis rate may be high; one series reported this rate to approach 50%. 44 The initial misdiagno sis rate may be high; one series reported this rate to approach 50%.…”

Section: Medical Evaluation Of the Patientmentioning

confidence: 99%