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Candida chorioretinitis in meningococcal meningitis
R Maddaluno1, C Nobili, P Cocucci
1Department of Infectious Diseases, Hospital of Frosinone.
Abstract:
A case of Candida chorioretinitis in a patient suffering from meningococcal meningitis, admitted to the Infectious Disease Department of Frosinone Hospital, Italy, is reported. Five days after the onset of meningitis during antibiotic and cortisone treatment the patient experienced oropharyngeal candidiasis, ocular pain and blurring of vision; two days later positive scotoma appeared. Ophthalmoscopic examination revealed probable Candida chorioretinitis. Treatment with intravenous fluconazole at high doses was employed with complete recovery of the right eye, while visual acuity of the left eye was 2/10. The use of long-term fluconazole at the doses reported, commonly employed in the treatment of systemic mycoses, improves prognosis.
Insights
This case report details Candida chorioretinitis in a meningococcal meningitis patient. High-dose intravenous fluconazole treatment led to significant visual recovery, improving prognosis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Mycology
Background:
- Meningococcal meningitis can predispose patients to opportunistic infections.
- Corticosteroid and antibiotic treatments for meningitis may increase the risk of fungal infections.
Observation:
- A patient with meningococcal meningitis developed oropharyngeal candidiasis and subsequent ocular symptoms including pain, blurred vision, and positive scotoma.
- Ophthalmoscopic examination indicated probable Candida chorioretinitis.
Findings:
- Intravenous fluconazole administered at high doses was used to treat the Candida chorioretinitis.
- The treatment resulted in complete visual recovery in the right eye and partial recovery (2/10 visual acuity) in the left eye.
Implications:
- This case highlights the potential for Candida chorioretinitis in immunocompromised patients with meningitis.
- Long-term, high-dose fluconazole therapy, typically used for systemic mycoses, shows promise in improving outcomes for ocular fungal infections.