Amphotericin B in the therapy of Candida glabrata endophthalmitis after penetrating keratoplasty.
OBJECTIVE
Candida glabrata is a rare cause of endophthalmitis after penetrating keratoplasty. Adequate therapy is still under discussion. With respect to severe complications and side effects of antifungal therapy, a substantial knowledge of sensitivity and resistance of the organism is necessary.


METHODS
We report on a 26-year-old man with a hyperacute onset of the infection only 10 hours after surgery. A combined therapy for fluconazole and steroids administered over 3 months had shown no effect on intraocular infection.


RESULTS
After topical and intracameral application of amphotericin B in combination with topical prednisolone 3 months after the onset of the endophthalmitis, the infection disappeared within 14 days, and the graft remained clear for 2 months. No toxic effects were noticed.


CONCLUSIONS
In the case presented here, topical and intracameral application of amphotericin B was sufficient and safe in the therapy for C. glabrata endophthalmitis after penetrating keratoplasty. Although typically the intraocular infection is first noticed within the first 2 weeks, a hyperacute onset has to be considered.
Grueb
Matthias
M
Department of Ophthalmology, University of Tuebingen, Tuebingen, Germany. matthias.grueb@med.uni-tuebingen.de
Rohrbach
Jens Martin
JM
Zierhut
Manfred
M
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D041221:Candida glabrata / Q000302:isolation & purification*; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D011183:Postoperative Complications; D011239:Prednisolone / Q000627:therapeutic use
D000935:Antifungal Agents; D005938:Glucocorticoids; D000666:Amphotericin B; D011239:Prednisolone