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Mycotic endophthalmitis in drug abusers
Abstract:
We diagnosed mycotic endophthalmitis by positive cultures in a 47-year-old man and a 42-year-old woman, both intravenous amphetamine users. Reinfection with a different fungal species was documented in one case. Rapid identification of the isolate, in vitro susceptibilities, selection of appropriate routes and dosages of antifungals, and the role of adjunctive corticosteroids are crucial factors in the management of these difficult cases. We prescribed antifungals and adjunctive corticosteroids, and our patients' vision improved.
Insights
This study details mycotic endophthalmitis in intravenous amphetamine users, highlighting the importance of prompt diagnosis and tailored antifungal treatment. Effective management, including corticosteroids, led to vision improvement in patients.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Intravenous drug use is a risk factor for serious infections.
- Fungal endophthalmitis is a severe intraocular infection that can lead to vision loss.
Observation:
- Two cases of mycotic endophthalmitis were diagnosed in intravenous amphetamine users.
- One patient experienced reinfection with a different fungal species.
Findings:
- Positive cultures confirmed fungal infection in both patients.
- Treatment involved antifungals and adjunctive corticosteroids.
- Both patients showed improved vision following treatment.
Implications:
- Rapid identification of fungal isolates and in vitro susceptibility testing are critical.
- Appropriate selection of antifungal routes and dosages is essential for successful outcomes.
- The role of corticosteroids in managing fungal endophthalmitis warrants consideration.