SEGMENTAL PATTERN OF INFILTRATES OVER RETINAL VESSELS IN FUNGAL ENDOPHTHALMITIS.
OBJECTIVE
To describe the case of a patient with Candida tropicalis endophthalmitis who presented with a pattern of segmentally distributed preretinal infiltrates overlying the retinal blood vessels.


METHODS
A retrospective chart review was performed. A 72-year-old East Indian male presented with redness, pain, photosensitivity, and loss of vision in the right eye for 1 month. He had been recently hospitalized for necrotizing pancreatitis and had been receiving intravenous medications as well as parenteral nutrition through a peripherally inserted central catheter.


RESULTS
Fundus examination revealed moderate vitreous cells and infiltrates, including a segmental pattern of preretinal bead-like opacities along several blood vessels. The patient underwent emergent vitrectomy with injection of antibiotics and antifungal medications. Vitreous cultures grew C. tropicalis. The patient was treated with oral antifungal medication for 6 weeks. By 7 weeks after surgery, all infiltrates and inflammatory cells had completely resolved. The imaging and intraoperative observations suggest that the opacities behaved like infiltrates and were associated with vitreous rather than vascular inflammation.


CONCLUSIONS
A segmental pattern of preretinal infiltrates over retinal vessels can be a presenting feature in endogenous fungal endophthalmitis. The observations in this case may contribute to understanding the pathophysiology of the findings.
Department of Ophthalmology, Kaiser Permanente, Tustin, California.
Suri N
SN
Appa
D000368:Aged; D041022:Candida tropicalis / Q000302:isolation & purification; D002177:Candidiasis / Q000473:pathology*; D009877:Endophthalmitis / Q000382:microbiology / Q000473:pathology*; D015821:Eye Infections, Fungal / Q000473:pathology*; D006801:Humans; D008297:Male; D012171:Retinal Vessels / Q000473:pathology*; D012189:Retrospective Studies