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An unusual case of cryptococcal endophthalmitis
P H Custis1, J A Haller, E de Juan
1Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, Maryland, USA.
Retina (Philadelphia, Pa.)
|January 1, 1995
Summary
This study highlights a rare case of ocular cryptococcosis diagnosed via vitreous biopsy. Antemortem diagnosis and treatment with fluconazole led to culture negativity, improving outcomes for cryptococcal endophthalmitis.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Cryptococcal endophthalmitis is a rare condition, often diagnosed late.
- Limited guidelines exist for its identification and management.
- This case involves a patient with chronic uveitis.
Observation:
- A patient with chronic uveitis presented with culture-positive cryptococcal endophthalmitis.
- Diagnosis was achieved through vitreous biopsy during retinal detachment repair.
- The patient received a 5-month course of oral fluconazole.
Findings:
- The patient became culture-negative after fluconazole treatment.
- Despite negative cultures, visual acuity declined due to hyphema and hypotony.
- The causative organism was identified as Cryptococcus laurentii, a novel ocular pathogen.
Implications:
- Cryptococcal disease can be diagnosed antemortem via vitreous biopsy.
- This diagnosis should be considered in chronic uveitis cases.
- Cryptococcus laurentii is identified as a new cause of ocular cryptococcosis.
- Fluconazole demonstrated efficacy in achieving culture negativity and resolving uveitis.