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[Endogenous Candida dubliniensis endophtalmitis. First case in Mexico]
Luis Othon Gittins-Núñez1, Fabiola Hernández-Núñez
1Médico residente, Hospital de Oftalmología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. gittinsothon@hotmail.com.
Background:
Candida endophthalmitis is related to immunosuppression state, intravenous catheters, invasive procedures and parenteral feeding. It is estimated that between 2% and 10% of endophthalmitis are endogenous, within fungal etiology the most frequently isolated microorganism is Candida albicans. The infection by C. dubliniensis is reported in less than 2 % of the cases of infection by Candida at systemic level and few reported cases of endophthalmitis. The clinical presentation is poor vision , vitritis, cottony deposits, chorioretinitis, and necrosis. The confirmatory diagnosis must be made with vitreous culture and the treatment is based on combination of vitrectomy and intravitreal antifungal.
Clinical Case:
It is reported a case of a patient with enterocutaneous fistula, long hospital stay with parental nutrition that cause endophthalmitis without immunosuppression.
Conclusions:
Endogenous endophthalmitis by C. dubliniensis is barely documented in the literature. Candida endophthalmitis should always be considered in patients with risk factors, in order to provide timely diagnosis and appropriate management, yet the prognosis in these patients is poor for function and organ preservation and for life from complications involving these patients from associated pathologies.
Insights
Endogenous endophthalmitis caused by Candida dubliniensis is rare, even in patients with risk factors like long-term parenteral nutrition. Early diagnosis and treatment are crucial for managing this severe fungal eye infection.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Candida endophthalmitis often arises in immunocompromised patients or those with invasive procedures.
- Candida albicans is the most common fungal cause, while Candida dubliniensis infections are rare.
- Risk factors include intravenous catheters, invasive procedures, and parenteral feeding.
Observation:
- A case of endogenous endophthalmitis caused by Candida dubliniensis is presented.
- The patient had an enterocutaneous fistula and required prolonged parenteral nutrition.
- Notably, the patient was not immunocompromised.
Findings:
- Candida dubliniensis endogenous endophthalmitis is infrequently documented.
- Clinical signs include poor vision, vitritis, cottony deposits, chorioretinitis, and necrosis.
- Diagnosis requires vitreous culture; treatment involves vitrectomy and intravitreal antifungals.
Implications:
- This case highlights the importance of considering Candida endophthalmitis in at-risk patients, even without immunosuppression.
- Timely diagnosis and management are critical for visual function and organ preservation.
- Prognosis remains guarded due to potential complications and associated pathologies.
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