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Cryptococcal endophthalmitis: case report and review.

J R Crump1, S G Elner, V M Elner

  • 1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 1, 1992
PubMed
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Cryptococcus neoformans can infect the eye, causing serious vision loss. Early diagnosis of ocular cryptococcosis is crucial for better patient outcomes.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Mycology

Background:

  • Cryptococcus neoformans is an opportunistic fungus that commonly affects the central nervous system (CNS).
  • Ocular complications of CNS cryptococcosis typically involve cranial nerve palsies or papilledema due to increased intracranial pressure.
  • Intraocular cryptococcosis is a rare manifestation, with only 27 cases reported over 23 years.

Observation:

  • Intraocular infection presented primarily as chorioretinal lesions and vitritis.
  • Underlying conditions were identified in 41% of patients.
  • Ocular lesions preceded CNS symptoms in 27% of patients with central nervous system involvement.

Findings:

  • Diagnosis was confirmed histologically via aqueous or vitreous humor analysis in 7 patients.

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  • Diagnosis was established post-mortem or after enucleation in 8 patients.
  • Severe visual impairment was a common outcome of ocular involvement, with visual recovery being infrequent.

    • Implications:

    • Ocular cryptococcosis can be an early indicator of systemic infection.
    • Prompt recognition and therapeutic intervention are essential for potentially improving visual prognosis.
    • Further research into early diagnostic markers and treatment strategies for intraocular cryptococcosis is warranted.