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Candida endophthalmitis: an unusual complication of prolonged intravenous access
M Vose1, S Beatty, S J Charles
1Manchester Royal Eye Hospital, Oxford Road, Manchester M13 9WL, UK.
Abstract:
A 16 year old boy awaiting a defunctioning colostomy for Crohn's disease complained of reduced vision in his left eye. Four weeks previously candida had been isolated from his central line used for parenteral feeds. Fundal examination of the left eye revealed a macular abscess with a classic "string of pearls" appearance of multiple vitreous abscesses. This was treated with pars plana vitrectomy and intravitreal antifungal therapy. Microbiological studies confirmed a diagnosis of candida endophthalmitis.
Insights
A teenage Crohn's patient developed Candida endophthalmitis, a serious eye infection, after a central line fungal contamination. Prompt treatment involving vitrectomy and antifungal medication was crucial for managing this vision-threatening condition.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Gastroenterology
Background:
- A 16-year-old male with Crohn's disease requiring a colostomy.
- History of Candida species isolated from a central line used for parenteral nutrition.
Observation:
- Patient presented with decreased vision in the left eye.
- Fundal examination revealed a macular abscess and a "string of pearls" appearance indicative of vitreous abscesses.
Findings:
- Microbiological studies confirmed Candida endophthalmitis.
- The infection was associated with prior central line candidemia.
Implications:
- Highlights the risk of disseminated fungal infections in immunocompromised patients.
- Emphasizes the importance of early diagnosis and aggressive treatment for Candida endophthalmitis to preserve vision.
- Underscores the need for vigilance regarding central line-associated infections in patients with inflammatory bowel disease.