Phacoemulsification in isolated endogenous Candida albicans anterior uveitis with lens abscess in an intravenous methadone user.
We report the clinical course of a 31-year-old former intravenous drug user on methadone substitution therapy who injected methadone mixed with orange juice. She developed isolated metastatic Candida albicans anterior uveitis, which was treated with adequate systemic and local antifungal therapy. The uveitis regressed, but despite adequate local and systemic treatment, a lens abscess developed. Phacoemulsification and endocapsular intraocular lens implantation were performed, and the patient recovered 20/20 visual acuity in the affected eye. In patients with a history of injection drug use, persisting intravenous drug or substitution therapy abuse must be considered. Quick diagnosis and adequate treatment can prevent the development of widespread C albicans endophthalmitis, which has a poor visual prognosis. Early administration of antifungal and surgical therapy is crucial for achieving good functional results.
Trpin
Simon
S
Department of Ophthalmology, Maribor Teaching Hospital, Maribor, Slovenia. simon.trpin@guest.arnes.si
Gracner
Tomaz
T
Pahor
Dusica
D
Gracner
Bojan
B
D000038:Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D007905:Lens Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D019654:Lens Implantation, Intraocular; D008691:Methadone; D009294:Narcotics; D018918:Phacoemulsification; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*
D000935:Antifungal Agents; D009294:Narcotics; D008691:Methadone