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Cases of endophthalmitis caused by Candida albicans and Candida dubliniensis identified via internal transcribed
Kazunobu Asao1, Noriyasu Hashida2, Kazuichi Maruyama2,3,4
1Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan. kazunobu.asao@ophthal.med.osaka-u.ac.jp.
Background:
We report two cases of fungal endophthalmitis induced by Candida species identified based on internal transcribed spacer 1 (ITS1) sequencing.
Case Presentation:
In two cases, endophthalmitis was suspected, and the patients underwent pars plana vitrectomy. Case 1 was a 64-year-old woman with a history of cataract surgery 10 days prior. She had a history of anal primary melanoma, which metastasized throughout the body and subsequently relapsed. Vitreous culture and ITS-1 deep sequencing revealed the presence of the rare fungus, Candida dubliniensis. Case 2 was a 54-year-old man with a history of liver cancer and kidney failure. Culture methods and ITS1 deep sequencing both revealed the presence of Candida albicans. Both patients exhibited good visual prognoses after treatment with topical and systemic antibiotics.
Conclusions:
We present two cases of fungal endophthalmitis caused by two Candida species identified by both the culture method and ITS1 deep sequencing. The fungal pathogen was identified by ITS deep sequencing three days after sample submission; the culture method yielded results after 1 week. These findings support the applicability of ITS1 sequencing for timely pathogen identification for cases of fungal endophthalmitis and provide detailed taxonomic information at the species level.
Insights
Rapid identification of fungal endophthalmitis pathogens using internal transcribed spacer 1 (ITS1) sequencing is crucial. This method offers faster species-level identification compared to traditional cultures, aiding timely treatment.
Area of Science:
- Ophthalmology
- Medical Mycology
- Molecular Diagnostics
Background:
- Fungal endophthalmitis is a severe intraocular infection that can lead to vision loss.
- Accurate and rapid identification of causative fungal species is essential for effective treatment.
- Traditional culture methods for fungal identification can be time-consuming.
Observation:
- Two cases of fungal endophthalmitis were investigated.
- Patients underwent pars plana vitrectomy for diagnosis and treatment.
- Case 1: A 64-year-old woman with a history of melanoma developed endophthalmitis post-cataract surgery.
- Case 2: A 54-year-old man with liver cancer and kidney failure presented with endophthalmitis.
Findings:
- Internal transcribed spacer 1 (ITS1) deep sequencing identified Candida dubliniensis in Case 1.
- ITS1 deep sequencing and culture identified Candida albicans in Case 2.
- ITS1 sequencing provided species-level identification in 3 days, while cultures took 1 week.
Implications:
- ITS1 sequencing is a valuable tool for rapid and accurate diagnosis of fungal endophthalmitis.
- Faster pathogen identification facilitates prompt and targeted therapeutic interventions.
- This molecular approach enhances species-level taxonomic resolution for Candida infections.
