title: Bilateral Candida albicans endophthalmitis associated with an infected deep venous thrombus.
abstract: BACKGROUND
  To describe the clinical and histopathologic findings in a patient with bilateral Candida albicans endophthalmitis due to an infected deep venous thrombus.
  
  
  METHODS
  A 43-year-old patient with bilateral Candida albicans endophthalmitis due to an infected central venous thrombus. The patient's ophthalmology and hospital charts were reviewed. Histopathologic sections of the Candida albicans retinal granuloma were examined under light microscopy.
  
  
  METHODS
  Our patient had multiple blood cultures positive for Candida albicans owing to an infected subclavicular venous thrombosis. Bilateral Candida albicans endophthalmitis was diagnosed. Bilateral vitrectomy and membrane peeling for macular traction retinal detachments were performed. In the right eye, a large retinal granuloma was excised during surgery to adequately relieve traction on the macula. Vision improved in both eyes after surgery. Histopathologic findings revealed branching hyphae surrounded by giant cells, endothelial cell-lined vascular channels, and inflammatory cells.
  
  
  CONCLUSIONS
  This is the first report of an infected deep venous thrombosis causing bilateral endogenous endophthalmitis. Appropriate management of these patients requires clear differentiation between endogenous chorioretinitis and endophthalmitis. Patients with documented fungemia should have a dilated fundus examination on a regular basis until complete clearance of the infection.
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Brigham & Women's Hospital, and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02114, USA. jarroyo@caregroup.harvard.edu
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Arroyo
authors.forename: Deisy V
authors.initials: DV
authors.lastname: Bula
authors.forename: Calvin A
authors.initials: CA
authors.lastname: Grant
authors.forename: Timothy
authors.initials: T
authors.lastname: Murtha
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001485:Basement Membrane / Q000601:surgery; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D009877:Endophthalmitis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D015821:Eye Infections, Fungal / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D006099:Granuloma / Q000382:microbiology / Q000601:surgery; D006801:Humans; D008297:Male; D012170:Retinal Vein Occlusion / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D014821:Vitrectomy
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B