Mycotic endophthalmitis in drug abusers.
We diagnosed mycotic endophthalmitis by positive cultures in a 47-year-old man and a 42-year-old woman, both intravenous amphetamine users. Reinfection with a different fungal species was documented in one case. Rapid identification of the isolate, in vitro susceptibilities, selection of appropriate routes and dosages of antifungals, and the role of adjunctive corticosteroids are crucial factors in the management of these difficult cases. We prescribed antifungals and adjunctive corticosteroids, and our patients' vision improved.
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000662:Amphetamines / Q000008:administration & dosage*; D000666:Amphotericin B / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology; D001228:Aspergillosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D002175:Candida / Q000187:drug effects; D002176:Candida albicans / Q000187:drug effects; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D003022:Clotrimazole / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D005260:Female; D005437:Flucytosine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000150:complications*
D000662:Amphetamines; D000935:Antifungal Agents; D000666:Amphotericin B; D011239:Prednisolone; D005437:Flucytosine; D003022:Clotrimazole; D011241:Prednisone