Candida Keratitis And Endopthalmitis

This case report presents the development of Candida keratitis and endophtalmitis in an immunosuppressed patient. Candida albicans is an opportunistic fungal pathogen that can cause keratitis and endophthalmitis, particularly in immunosuppressed individuals.

Department of Ophthalmology, İstanbul Faculty of Medicine, İstanbul University, İstanbul Türkiye.

İNTRODUCTİON 
This case report presents the development of Candida keratitis and endophtalmitis in an immunosuppressed patient. Candida albicans is an opportunistic fungal pathogen that can cause keratitis and endophthalmitis, particularly in immunosuppressed individuals.

PATİENT AND CLİNİCAL FİNDİNGS 
A 43-year-old woman with a history of Sjögren syndrome and hypogammaglobulinemia, who had been on long-term oral prednisolone therapy (5 mg/day for approximately 20 years), presented with a 4-day history of decreased vision in her left eye. At presentation, visual acuity in the left eye was limited to hand motion. Anterior segment examination revealed that the corneal graft was edematous, and an infiltrate was observed at the graft–host junction.Blood cultures obtained from the patient were negative. Candida growth was detected in the vitreous samples

Diagnosis, Intervention, and Outcomes:
The patient was hospitalized with a preliminary diagnosis of fungal keratitis with possible intraocular involvement. An anterior chamber paracentesis was performed, followed by intracameral injections of vancomycin (1 mg/0.1 mL), ceftazidime (2 mg/0.1 mL), and voriconazole (100 µg/0.1 mL). Microbiological analysis subsequently confirmed the growth of Candida albicans.

Candida keratitis may progress to intraocular infection in immunosuppressed patients. Early clinical suspicion, prompt microbiological confirmation, and timely initiation of antifungal therapy are essential to preserve vision.