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Cryptococcal Meningitis Presenting as Endophthalmitis in an Otherwise Asymptomatic Patient

Travis J Peck1, Michael J Ammar1,2, James P Dunn1,2

  • 1Department of Ophthalmology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA.

Journal of Vitreoretinal Diseases
|April 3, 2023
PubMed
Abstract

Insights

Cryptococcal endophthalmitis can be the first sign of a widespread infection. Prompt diagnosis and treatment are crucial, as this condition may indicate meningitis, even without typical symptoms.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Mycology

Background:

  • Cryptococcus neoformans commonly affects the central nervous system, potentially causing fatal meningitis.
  • Cryptococcal endophthalmitis is a rare ocular manifestation, usually associated with disseminated disease.

Observation:

  • A 66-year-old immunocompromised patient presented with blurry vision and was diagnosed with cryptococcal endophthalmitis.
  • The patient had an underlying bloodstream and central nervous system infection.

Findings:

  • Intravenous and intravitreal antifungal treatment was administered.
  • A significant subretinal mass lesion persisted despite treatment.

Implications:

  • Cryptococcal endophthalmitis can be the initial clinical presentation of disseminated cryptococcosis.
  • Positive vitreous cultures for Cryptococcus necessitate a presumption of meningitis, irrespective of symptoms.
Keywords:
Cryptococcus neoformanscryptococcal endophthalmitiscryptococcal meningitisendogenous endophthalmitisendophthalmitisfungal endophthalmitis

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