Candida Endophthalmitis Treated Successfully with Isavuconazole - A Case Report

Candida endophthalmitis is a serious complication of candidemia. Diagnosis requires identification of ocular lesions on dilated fundoscopy, aided by isolation of the organism from blood and/or vitreous humor. However, the initial ophthalmological examination may be negative in some cases. Experience with isavuconazole for the treatment of Candida endophthalmitis is limited. We present a case of a 65-year-old woman with metastatic breast cancer on chemotherapy who developed Candida dubliniensis endophthalmitis with initial negative ophthalmological examination. She was treated with vitrectomy and 6 weeks of oral fluconazole. Despite vitrectomy and culture-directed antifungal treatment, management was complicated by lack of response to fluconazole and intolerance to other antifungals, necessitating the use of isavuconazole, which proved efficacious.

Multiple Intravitreal Liposomal Amphotericin B for a Case of Candida glabrata Endophthalmitis

We report a case of <i>Candida glabrata</i> endophthalmitis which was effectively treated by intravitreal liposomal amphotericin B (L-AMB) injection. A 72-year-old man was referred to our department for positive blood culture of <i>Candida glabrata</i>. First ophthalmologic examination revealed a chorioretinal lesion in left eye, and the patient was diagnosed as possible candida chorioretinitis. Despite systemic antifungal therapy, his chorioretinal lesion increased in both eyes and complicated by vitritis. Intravitreal administration of L-AMB was introduced for probable candida endophthalmitis. Finally, improvement of vitritis and regression of chorioretinal lesions were obtained by total of 9 times intravitreal injection. Our case suggests the safety and efficacy of intravitreal L-AMB injection for <i>Candida glabrata</i> endophthalmitis.