Uso do fluconazol endovenoso no tratamento da endoftalmite fúngica endógena: relato de caso

Dotto, Patrícia de Freitas; Rodrigues, Luciana Duarte; Fernandes, Maria de Lourdes Brandão; Figueira, Bettina Barbosa Duque; Takahashi, Walter Yukihiko; Carani, José Carlos Eudes; Serracarbassa, Pedro Durães

doi:10.1590/s0004-27492005000400022

Cited by 6 publications

(5 citation statements)

References 43 publications

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“…The authors report a case of bilateral endogenous fungal endophthalmitis following nephrolithiasis complicated by obstructive pyelonephritis in an adult female patient who had some risk factors for fungal infection known as: recent hospitalization, central venous access, and severe upper urinary tract infection (2) . Fungal endophthalmitis is usually an indolent bilateral infection in ¼ of cases, and the most common symptoms are visual blur and photophobia.…”

Section: Discussionmentioning

confidence: 99%

“…In the last decades, the increase in incidence has been influenced by several factors, such as the diffusion of antibiotic therapy, intravenous catheterization, the use of prolonged parenteral nutrition, immunosuppression caused by systemic disease or induced immunosuppressive therapy, the use of illicit drugs and prematurity at birth (2) . Currently, amphotericin B is used as first-line treatment in fungal endophthalmitis, despite its local and systemic toxicity.…”

mentioning

confidence: 99%

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Bilateral endogenous fungal endophthalmitis secondary obstructive pyelonephritis

Barbosa¹,

Wanzeler²,

Gomes³

et al. 2017

Revista Brasileira De Oftalmologia

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The authors declare no conflicts of interests. RESUMOOs autores relatam um caso de endoftalmite fúngica endógena bilateral ocorrida após nefrostomia descompressiva decorrente de pielonefrite obstrutiva secundária a nefrolitíase tratada, inicialmente, com injeção intravítrea de voriconazol (100 ìg/0.1 ml) porém evoluiu sem resposta terapêutica sendo necessária a vitrectomia posterior (23G).Descritores: Pielonefrite/complicações; Endoftalmite/etiologia; Endoftalmite/quimioterapia; Infecções oculares fúngicas; Voriconazol/uso terapêutico; Vitrectomia; Relatos de casos ABSTRACT The authors report a case of bilateral endogenous fungal endophthalmitis occurred after decompression nephrostomy due to secondary obstructive pyelonephritis the treated nephrolithiasis initially with intravitreal voriconazole (100 mg / 0.1 ml) but evolved without therapeutic response requiring the posterior vitrectomy (23G).

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Bilateral endogenous fungal endophthalmitis secondary obstructive pyelonephritis

Barbosa¹,

Wanzeler²,

Gomes³

et al. 2017

Revista Brasileira De Oftalmologia

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“…Fluconazole has excellent penetration into the vitreous (35). A case of endogenous Candida albicans endophthalmitis in a newborn refractory to intravenous amphotericin B that responded to fluconazole has been reported (14). Itraconazole is active against a variety of fungi and is well absorbed orally in doses of 50 to 400 mg daily.…”

Section: Discussionmentioning

confidence: 99%

“…Systemically administered voriconazole which would be given simultaneously with intravitreal injection would penetrate into the vitreous. In addition to voriconazole, fluconazole also penetrates well into the vitreous, and both agents have been effective in treating fungal endophthalmitis through intravenous administration (14,15). Intravitreal injection of liposomal amphotericin B, which has less toxicity than amphotericin B, was used to treat a patient with bilateral endogenous Candida endophthalmitis (16).…”

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confidence: 99%

Pharmacokinetics and Safety of Intravitreal Caspofungin

Shen

Liang

Wang

et al. 2014

Antimicrob Agents Chemother

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Caspofungin exhibits potent antifungal activities against Candida and Aspergillus species. The elimination rate and retinal toxicity of caspofungin were determined in this study to assess its pharmacokinetics and safety in the treatment of fungal endophthalmitis. Intravitreal injections of 50 g/0.1 ml of caspofungin were administered to rabbits. Levels of caspofungin in the vitreous and aqueous humors were determined using high-performance liquid chromatography (HPLC) at selected time intervals (10 min and 1, 2, 4, 8, 16, 24, and 48 h), and the half-lives were calculated. Eyes were intravitreally injected with caspofungin to obtain concentrations of 10 g/ml, 50 g/ml, 100 g/ml, and 200 g/ml. Electroretinograms were recorded 4 weeks after injections, and the injected eyes were examined histologically. The concentrations of intravitreal caspofungin at various time points exhibited an exponential decay with a half-life of 6.28 h. The mean vitreous concentration was 6.06 ؎ 1.76 g/ml 1 h after intravitreal injection, and this declined to 0.47 ؎ 0.15 g/ml at 24 h. The mean aqueous concentration showed undetectable levels at all time points. There were no statistical differences in scotopic a-wave and b-wave responses between control eyes and caspofungin-injected eyes. No focal necrosis or other abnormality in retinal histology was observed. Intravitreal caspofungin injection may be considered to be an alternative treatment for fungal endophthalmitis based on its antifungal activity, lower retinal toxicity, and lower elimination rate in the vitreous. More clinical data are needed to determine its potential role as primary therapy for fungal endophthalmitis.

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“…However, there are reports of successful treatment of endogenous endophthalmitis by Candida spp. with FCZ (89)(90)(91) . Even though its ocular penetration is superior to KCZ, in vitro and in vivo studies showed that the antifungal spectrum of FCZ is narrower.…”

Section: -Fluconazolementioning

confidence: 99%

Antifúngicos em infecções oculares: drogas e vias de administração

Müller¹,

Kara‐José²,

Castro³

2013

Rev. bras.oftalmol.

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RESUMOO tratamento das infecções oculares por fungos representa um desafio à prática oftalmológica. Para obtermos resposta terapêutica adequada, além do uso da droga correta, é necessária a administração desta de forma eficaz. Este manuscrito reúne informações a respeito das principais drogas antifúngicas utilizadas em infecções oculares, suas concentrações e principais vias de administração.

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Uso do fluconazol endovenoso no tratamento da endoftalmite fúngica endógena: relato de caso

Cited by 6 publications

References 43 publications

Bilateral endogenous fungal endophthalmitis secondary obstructive pyelonephritis

Bilateral endogenous fungal endophthalmitis secondary obstructive pyelonephritis

Pharmacokinetics and Safety of Intravitreal Caspofungin

Antifúngicos em infecções oculares: drogas e vias de administração

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