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Candida parapsilosis endothelial abscess following phacoemulsification and intraocular lens implantation

Poster Details

First Author: D.Gosling UK

Co Author(s):                        

Abstract Details

Purpose:

Case report of a rare complication of cataract surgery: candida parapsilosis endothelial abscess and endophthalmitis.

Setting:

Royal Hallamshire hospital, Sheffield teaching hospitals NHS trust, Sheffield, United Kingdom

Methods:

A 72 year old male, with type 2 diabetes mellitus, presented with a red eye, 6 weeks after uneventful cataract surgery. He had a mildly injected eye with 6/9 visual acuity, a 0.5mm hypopyon and a small corneal endothelial abscess at the paracentesis site.

Results:

He underwent anterior chamber tap, empirical intravitreal antibiotics and commenced on topical steroid and antibiotics. Microbiology yielded no organism and his condition appeared to improve. After 4 weeks, intraocular inflammation recurred and he underwent debridement of the endothelial abscess with anterior chamber wash out. Visual acuity was 6/6. Microbiological culture identified the organism as candida parapsilosis. Treatment was with an extended course of oral fluconazole and topical steroid, and later, an intravitreal injection of amphotericin B. After 12 months, signs of intraocular inflammation recurred when ceasing topical steroid and antimicrobial treatment. Diagnostic and therapeutic vitrectomy is being considered.

Conclusions:

Candida parapsilosis is a rare cause of sporadic post-operative endophthalmitis in the UK. Though the organism appears to be fairly indolent and the eye maintains good visual acuity, eradication and resolution of the intraocular inflammation has not been achieved.

Financial Disclosure:

NONE

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