Journal Article

<i>Candida albicans</i> Endophthalmitis in Brown Heroin Addicts: Response to Early Vitrectomy Preceded and Followed by Antifungal Therapy

C. Martínez-Váquez, J. Fernández-Ulloa, J. Bordón, B. Sopeña, J. de la Fuente, A. Ocampo and M. Rubianes

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 5, pages 1130-1133
Published in print November 1998 | ISSN: 1058-4838
Published online November 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514972
Candida albicans Endophthalmitis in Brown Heroin Addicts: Response to Early Vitrectomy Preceded and Followed by Antifungal Therapy

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The management of Candida albicans endophthalmitis in intravenous drug abusers (IVDAs) has yet to be established. Early vitrectomy was previously reported as a promising treatment for C. albicans endophthalmitis. In our series, C. albicans endophthalmitis was diagnosed for 15 IVDAs. Funduscopic examinations confirmed severe vitritis in 12 patients and chorioretinitis in three. Blood and vitreal cultures were positive for C. albicans for seven and eight patients, respectively. Patients with vitritis received antifungal therapy before and after vitrectomy. Amphotericin B or fluconazole therapy was given according to the physician's preference. Vitrectomy was defined as early if it was performed within 1 week after the diagnosis of vitritis. All seven patients who underwent early vitrectomy had a favorable response without complications. Two of three patients who underwent late vitrectomy developed blindness or scotoma. Blindness was also described in two patients with vitritis who did not undergo vitrectomy. Early vitrectomy preceded and followed by antifungal therapy seems to be appropriate management of vitritis in IVDAs.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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