Bilateral endogenous Candida endophthalmitis after induced abortion.
OBJECTIVE
Analysis of the development and treatment of bilateral Candida endophthalmitis after induced abortion in a healthy 31-year-old patient.


METHODS
A diagnosis of bilateral Candida endophthalmitis was established on the basis of positive vaginal culture, serological finding, and culture for Candida hyphae from the vitreous aspirate. The treatment of the disease consisted of prolonged systemic therapy with amphotericin B and fluconazole and pars plana vitrectomy with intravitreal amphotericin B injection.


RESULTS
After the combined systemic therapy with antibiotics, fungistatics, and corticosteroids proved to be insufficient, pars plana vitrectomy with intravitreal instillation of amphotericin B was performed, which led to the improvement of visual function. After surgery, visual function was maintained with prolonged systemic therapy with fluconazole and methylprednisolone.


CONCLUSIONS
Complicated induced abortion may cause bilateral Candida endophthalmitis in a young healthy woman. Elimination of the cause of fungemia and adequate systemic treatment did not cure bilateral endophthalmitis. Pars plana vitrectomy with intravitreal instillation of 5-microg amphotericin B proved as a method of choice in treating this severe ophthalmic disease.
Sikić
J
J
Department of Ophthalmology, Zagreb University Hospital Center, Croatia.
Vukojević
N
N
Katusić
D
D
Sarić
B
B
D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000382:microbiology / Q000601:surgery
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole