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Candida glabrata endophthalmitis treated successfully with caspofungin
Juan C Sarria1, Jay C Bradley, Ranya Habash
1Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX 77555-0435, USA. jcsarria@utmb.edu
Summary
Successful treatment of Candida glabrata endophthalmitis was achieved with intravenous caspofungin in a patient with renal insufficiency. This antifungal therapy avoided the need for amphotericin B, fluconazole, intravitreal agents, or surgery.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Endophthalmitis, an inflammation of the eye's interior, can be caused by fungal pathogens.
- Candida glabrata is an opportunistic fungus that can lead to severe infections, including endophthalmitis.
- Treatment challenges arise with drug-resistant strains and patient comorbidities like renal insufficiency.
Observation:
- A 39-year-old male presented with Candida glabrata endophthalmitis.
- The patient had underlying renal insufficiency, complicating treatment options.
- The infecting Candida glabrata strain exhibited resistance to conventional antifungal agents like fluconazole.
Findings:
- Intravenous caspofungin was administered for 28 days, resulting in successful treatment.
- The patient did not require intravitreal antifungal injections or surgical intervention (vitrectomy).
- Caspofungin demonstrated efficacy against a drug-resistant Candida glabrata strain in this case.
Implications:
- Caspofungin represents a viable therapeutic option for Candida endophthalmitis, particularly when other agents are contraindicated.
- This case highlights the potential for systemic caspofungin to manage fungal endophthalmitis without local interventions.
- Further research is warranted to define the role and optimal use of echinocandins in treating fungal endophthalmitis.