Endophthalmitis in a patient with disseminated cryptococcosis and AIDS who was treated with itraconazole.
We report a case of presumed cryptococcal endophthalmitis that occurred in a patient with severe disseminated cryptococcosis and AIDS. Multiple small, spherical lesions appeared bilaterally on the surface of the retina 2 weeks after cryptococcal meningitis was diagnosed; the lesions were associated with multiple blind spots, blurred vision, and the perception of flaring of light. Over the next week, many more lesions with adjacent hemorrhages appeared. Therapy with itraconazole over the next 3 months resulted in complete resolution of the lesions. Cryptococcal endophthalmitis is a rare disease. Fewer than 20 cases, including five in patients with AIDS, have previously been reported. None of these patients regained normal vision.
Denning
D W
DW
Department of Medicine, Santa Clara Valley Medical Center, San Jose, California 95128.
Armstrong
R W
RW
Fishman
M
M
Stevens
D A
DA
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D003453:Cryptococcosis / Q000150:complications / Q000188:drug therapy*; D009877:Endophthalmitis / Q000150:complications / Q000188:drug therapy*; D015821:Eye Infections, Fungal / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D017964:Itraconazole; D007654:Ketoconazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D012008:Recurrence
D000935:Antifungal Agents; D017964:Itraconazole; D007654:Ketoconazole