title: Candida (amphotericin-sensitive) lens abscess associated with decreasing arterial blood flow in a very low birth weight preterm infant.
abstract: In this report, we review the case of a candidal lens abscess in a premature infant girl who was 28 weeks' gestational age at birth. The culture obtained from the lens abscess grew Candida albicans sensitive to amphotericin B but resistant to flucytosine. This case is unique in that the infant developed a fungal lens cataract at 34 weeks' postconceptional age during the last week of a 30-day course of amphotericin B. The embryonic hyaloid artery system, which perfuses the developing lens, regresses between 29 and 32 weeks of gestation; thus, the mechanism for an infection of the lens may be inoculation of the lens by Candida before hyaloid artery system regression, followed by developmental loss of this blood supply, which makes the lens inaccessible to antimicrobial penetration. Candidal endophthalmitis with lens abscess is an uncommon morbidity that requires prompt recognition and surgical intervention for effective management.
authors.affiliation: Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Drohan
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Colby
authors.forename: Mary E
authors.initials: ME
authors.lastname: Brindle
authors.forename: Steven
authors.initials: S
authors.lastname: Sanislo
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Ariagno
mesh_terms: D000038:Abscess / Q000188:drug therapy* / Q000601:surgery*; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D002176:Candida albicans; D002177:Candidiasis / Q000188:drug therapy* / Q000601:surgery*; D002387:Cataract Extraction; D009877:Endophthalmitis; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007905:Lens Diseases / Q000188:drug therapy* / Q000601:surgery*; D007908:Lens, Crystalline / Q000098:blood supply* / Q000196:embryology / Q000601:surgery; D009880:Ophthalmic Artery / Q000196:embryology
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D005437:Flucytosine