CANDIDA ENDOPHTHALMITIS FROM THE REACTIVATION OF A DORMANT LENTICULAR FUNGAL ABSCESS IN A PREMATURE INFANT.
OBJECTIVE
To report a case of fungal endophthalmitis from reactivation of a dormant lenticular fungal abscess in a severely premature infant.


METHODS
Single retrospective case report.


RESULTS
A female born at 23 and 6/7 weeks and weighing 620 g was diagnosed at age 29 weeks post menstrual age with persistent tunica vasculosa lentis, lenticular opacity, and aggressive posterior retinopathy of prematurity, and received bilateral intravitreal injection of bevacizumab. At the time of injection she was receiving systemic antibiotics for sepsis and fungemia. The retinopathy of prematurity regressed, as did the tunica vasculosa lentis, but a small plaque remained on the lens. At 5.5 months of age, patient presented with hypopyon and elevated intraocular pressure. Culture of intraocular fluid demonstrated Candida albicans.


CONCLUSIONS
Candida lenticular abscess is a rare complication of systemic fungemia in premature infants. Bevacizumab-induced regression of tunica vasculosa lentis may have decreased the ability of systemically administered antifungal medications to reach the colonized lens.
*Department of Ophthalmology, University of Chicago, Chicago, Illinois; and †Retina Consultants, Ltd, Des Plaines, Illinois.
Fatoumata
F
Yanoga
Jose M
JM
Garcia-Gonzalez
Mark
M
Greenwald
Michael J
MJ
Shapiro
Michael P
MP
Blair
D000038:Abscess / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D000935:Antifungal Agents / Q000627:therapeutic use; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D009877:Endophthalmitis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D007905:Lens Diseases / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D007908:Lens, Crystalline / Q000382:microbiology*
D000935:Antifungal Agents