Gittins-Núñez LO, Hernández-Núñez F

Language: Spanish
References: 10
Page: 92-96
PDF size: 139.23 Kb.

ABSTRACT

Background: Candida endophthalmitis is related to immunosuppression state, intravenous catheters , invasive procedures and parenteral feeding. It is estimated that between 2% and 10% of endophthalmitis are endogenous, within fungal etiology the most frequently isolated microorganism is Candida albicans. The infection by C. dubliniensis is reported in less than 2 % of the cases of infection by Candida at systemic level and few reported cases of endophthalmitis. The clinical presentation is poor vision , vitritis, cottony deposits, chorioretinitis, and necrosis. The confirmatory diagnosis must be made with vitreous culture and the treatment is based on combination of vitrectomy and intravitreal antifungal .
Clinical case: It is reported a case of a patient with enterocutaneous fi stula, long hospital stay with parental nutrition that cause endophthalmitis without immunosuppression.
Conclusions: Endogenous endophthalmitis by C. dubliniensis is barely documented in the literature. Candida endophthalmitis should always be considered in patients with risk factors, in order to provide timely diagnosis and appropriate management, yet the prognosis in these patients is poor for function and organ preservation and for life from complications involving these patients from associated pathologies.

REFERENCES

1. Sullivan D.J, Morgan G, Pinjon E, et al. Comparison of the epidemiology, drug resistence mechanisms, and virulence of Candida dubliniensis and Candida albicans. FEMS Yeast Res 2004; 4:369-376.

2. Rosenberg E, Youssef DA, Safdar S, Third case of Candida Dubliniensis endogenous endophtalmitis in North America: case report and review of the literatura,Int Ophthalmol. 2013 Nov 14. [Epub ahead of print]

3. Moloney TP, Park,J, Candida Dubliniensis endophtalmitis: fi ve cases over 15 years,J Ophthalmic Infl amm Infect. 2013 Nov 19;3(1):66.

4. Peter G. Pappas, GuÍas de práctica clínica para el manejo de la candidiasis: actualización del 2009, de la Infectious Diseases Society of America, Clinical Infectious Diseases 2009; 48:T1–T35

5. Kalkanci A. Ocular Fungal Infections. Curr Eye Res 2010;18-21AL MOSAID A, SULLIVAN DJ, COLEMAN DC. Differentiation of Candida dubliniensis from Candida albicans on Pal´s Agar. J Clin Microbiol 2003; 41:4787-4789.

6. Zhang Y, Wang W.Treatment outcomes after pars plana vitrectomy for endogenous endophthalmitis. Retina 2005; 25: 746-750.

7. Turno K. Early vitrectomy and diagnostic testing in severe infectious posterior uveitis and endophthalmitis. Med Sci Monit 2010;16:296-300.

8. España E, Navea A, Díaz M. Retinitis y endoftalmitis por Candida en usuarios de drogas por vía parenteral. Oftalmo, Sociedades Oftalmológicas Españolas. Disponible en: http://www.oftalmo .com/publicaciones/ sida/CAP42.HTM

9. Jabra-Rizk MA, Falkler WA Jr, Merz WG, Baqui AAMA, Kelley JI, Meiller TF. Retrospective identifi - cation and characterization of Candida dubliniensis isolates among Candida albicans clinical laboratory isolates from human immunodefi ciency virus (HIV)- infected and non-HIV-infected individuals. J Clin Microbiol. 2000

10. Sallam A, Taylor SRJ, Khan A, McCluskey P, Lynn WA, Manku K, Pacheco PA, Lightman S. Factors determining visual outcome in endogenous Candida endophthalmitis. Retina.2012;3:1129–1134