[Candida infiltrations in the iris and lens during iritis and situation after sepsis]

Area of Science:

• Ophthalmology
• Infectious Diseases
• Mycology

Background:

• Intraocular Candida infections are rare but can cause significant vision loss, often presenting as chorioretinitis or endophthalmitis.
• Endogenous Candida infections typically arise secondary to Candida sepsis, frequently linked to gastrointestinal issues or invasive procedures.
• Corticosteroid therapy can predispose individuals to opportunistic fungal infections, including intraocular candidiasis.

Observation:

• A 35-year-old man developed Candida infiltrations in the lens capsule and behind the iris.
• This occurred after corticosteroid treatment for presumed HLA-B27-positive iritis.
• The patient had a prior severe intensive care stay with Candida sepsis following intestinal perforation.

Findings:

• Successful treatment was achieved using systemic, intracameral, and topical voriconazole.
• This case demonstrates a rare manifestation of intraocular candidiasis.

Implications:

• Caution is advised when using topical or systemic corticosteroids in patients with a history of Candida sepsis, even months after negative blood cultures.
• Early recognition and prompt treatment with antifungal agents are crucial for managing sight-threatening intraocular Candida infections.