Candida dubliniensis endophthalmitis: five cases over 15 years.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Mycology

Background:

• Candida dubliniensis is a recently identified fungal species, generally considered less pathogenic than Candida albicans.
• C. dubliniensis endophthalmitis is exceptionally rare, with limited prior case reports.
• This study investigates the clinical characteristics and outcomes of C. dubliniensis endophthalmitis.

Purpose of the Study:

• To describe the clinical features and outcomes of patients diagnosed with culture-proven Candida dubliniensis endophthalmitis.
• To compare the pathogenicity and outcomes of C. dubliniensis endophthalmitis with those of C. albicans endophthalmitis.

Main Methods:

• A multicenter, retrospective, consecutive case series design was employed.
• Data were collected from medical records of patients with C. dubliniensis endophthalmitis identified via vitreous/aqueous cultures.
• The study period spanned from June 1998 to June 2013, encompassing all public hospitals in Queensland, Australia.

Main Results:

• Six eyes from five patients (four male, one female; mean age 37 years) were identified.
• Four patients were intravenous drug users, and four had hepatitis C co-infection.
• All patients received systemic and intravitreal antifungal therapy and underwent vitrectomy; five eyes achieved visual acuity of 20/60 or better, with one poor outcome.

Conclusions:

• Candida dubliniensis endophthalmitis is a rare fungal infection predominantly seen in intravenous drug users.
• The condition can affect both HIV-positive and HIV-negative individuals.
• Compared to Candida albicans endophthalmitis, C. dubliniensis endophthalmitis presents with favorable visual outcomes and a low mortality rate.