Bilateral Endogenous Cryptococcal Endophthalmitis in an Immunocompetent Host Treated with Two Different Tailored Approaches
Endogenous fungal endophthalmitis is one of the most severe and rare ocular pathologies. Rarely, it occurs in healthy and immunocompetent people and is observed in both eyes. This case report describes diagnosis and treatment of a rare case of bilateral endogenous fungal endophthalmitis with differe...
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doaj-4870daf5c53145b1b704b40ad97bd9402020-11-25T01:44:29ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2020-01-01141 ND01 ND0210.7860/JCDR/2020/42713.13444Bilateral Endogenous Cryptococcal Endophthalmitis in an Immunocompetent Host Treated with Two Different Tailored ApproachesLuigi Sborgia0Alfredo Niro1Giancarlo Sborgia2Alessandra Sborgia3Giovanni Alessio4Department of Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Puglia, Italy.ASL Taranto, Eye Clinic, Hospital “S. G. MOSCATI”, Taranto, Puglia, Italy.Department of Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Puglia, Italy.ASL Taranto, Eye Clinic, Hospital “S. G. MOSCATI”, Taranto, Puglia, Italy.Department of Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Puglia, ItalyEndogenous fungal endophthalmitis is one of the most severe and rare ocular pathologies. Rarely, it occurs in healthy and immunocompetent people and is observed in both eyes. This case report describes diagnosis and treatment of a rare case of bilateral endogenous fungal endophthalmitis with different degree of severity. Smear and culture of vitreous samples were not helpful in confirming the aetiology but blood samples revealed Cryptococcus neoformans antigen. Systemic therapy was set up with voriconazole. Vitrectomy with intravitreal injection of voriconazole was performed in left eye as it was clincally worst, while only intravitreal injection of antifungal drug was performed in right eye. After 3 months of follow-up, a relevant functional and morphologic improvement was reported in both eyes. Cryptococcal endogenous endophthalmitis is a challenge for ophthalmologists. Prompt aggressive treatments tailored to the known aetiology and clinical conditions are imperative to achieve good morpho-functional recovery in case of bilateral involvement with different degree of severity.https://jcdr.net/articles/PDF/13444/42713_F(KM)_CE[Ra1]_KM_PF1(AJ_SL)_PN(SL).pdfcryptococcus neoformansendogenous endophthalmitisintravitreal injectionvitrectomyvoriconazole |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Luigi Sborgia Alfredo Niro Giancarlo Sborgia Alessandra Sborgia Giovanni Alessio |
spellingShingle |
Luigi Sborgia Alfredo Niro Giancarlo Sborgia Alessandra Sborgia Giovanni Alessio Bilateral Endogenous Cryptococcal Endophthalmitis in an Immunocompetent Host Treated with Two Different Tailored Approaches Journal of Clinical and Diagnostic Research cryptococcus neoformans endogenous endophthalmitis intravitreal injection vitrectomy voriconazole |
author_facet |
Luigi Sborgia Alfredo Niro Giancarlo Sborgia Alessandra Sborgia Giovanni Alessio |
author_sort |
Luigi Sborgia |
title |
Bilateral Endogenous Cryptococcal Endophthalmitis in an Immunocompetent Host Treated with Two Different Tailored Approaches |
title_short |
Bilateral Endogenous Cryptococcal Endophthalmitis in an Immunocompetent Host Treated with Two Different Tailored Approaches |
title_full |
Bilateral Endogenous Cryptococcal Endophthalmitis in an Immunocompetent Host Treated with Two Different Tailored Approaches |
title_fullStr |
Bilateral Endogenous Cryptococcal Endophthalmitis in an Immunocompetent Host Treated with Two Different Tailored Approaches |
title_full_unstemmed |
Bilateral Endogenous Cryptococcal Endophthalmitis in an Immunocompetent Host Treated with Two Different Tailored Approaches |
title_sort |
bilateral endogenous cryptococcal endophthalmitis in an immunocompetent host treated with two different tailored approaches |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2020-01-01 |
description |
Endogenous fungal endophthalmitis is one of the most severe and rare ocular pathologies. Rarely, it occurs in healthy and immunocompetent people and is observed in both eyes. This case report describes diagnosis and treatment of a rare case of bilateral endogenous fungal endophthalmitis with different degree of severity. Smear and culture of vitreous samples were not helpful in confirming the aetiology but blood samples revealed Cryptococcus neoformans antigen. Systemic therapy was set up with voriconazole. Vitrectomy with intravitreal injection of voriconazole was performed in left eye as it was clincally worst, while only intravitreal injection of antifungal drug was performed in right eye. After 3 months of follow-up, a relevant functional and morphologic improvement was reported in both eyes. Cryptococcal endogenous endophthalmitis is a challenge for ophthalmologists. Prompt aggressive treatments tailored to the known aetiology and clinical conditions are imperative to achieve good morpho-functional recovery in case of bilateral involvement with different degree of severity. |
topic |
cryptococcus neoformans endogenous endophthalmitis intravitreal injection vitrectomy voriconazole |
url |
https://jcdr.net/articles/PDF/13444/42713_F(KM)_CE[Ra1]_KM_PF1(AJ_SL)_PN(SL).pdf |
work_keys_str_mv |
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