Candida glabrata endophthalmitis following penetrating keratoplasty. 2009

Matthew C Caldwell, and John R Perfect, and Alan N Carlson, and Alan D Proia
Duke University Eye Center, Duke University Medical Center, Durham, North Carolina 27701, USA. matthew.caldwell@duke.edu

We report a case of Candida glabrata endophthalmitis following penetrating keratoplasty in a 57-year-old man. The infection was thought to be treated successfully with intravitreal amphotericin B but flared 7 months later following cataract extraction and eventually required explantation of the intraocular lens and therapeutic keratoplasty. The literature regarding this rare infection is reviewed. Candida glabrata, an uncommon ocular pathogen, is being reported with increasing frequency and with a notable predilection for post-keratoplasty eyes. In the 10 reported cases, there is 100% concordance between host and donor tissue cultures. In half the cases, there was a latent period of several months. These infections can be difficult to treat because C glabrata is often resistant to the antifungal agents commonly used to treat Candida albicans.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009877 Endophthalmitis Suppurative inflammation of the tissues of the internal structures of the eye frequently associated with an infection. Ophthalmia,Infectious Endophthalmitis,Endophthalmitides,Endophthalmitides, Infectious,Endophthalmitis, Infectious,Infectious Endophthalmitides,Ophthalmias
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002177 Candidiasis Infection with a fungus of the genus CANDIDA. It is usually a superficial infection of the moist areas of the body and is generally caused by CANDIDA ALBICANS. (Dorland, 27th ed) Candida Infection,Moniliasis,Candida Infections,Candidiases,Infection, Candida,Moniliases
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000935 Antifungal Agents Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from FUNGICIDES, INDUSTRIAL because they defend against fungi present in human or animal tissues. Anti-Fungal Agents,Antifungal Agent,Fungicides, Therapeutic,Antibiotics, Antifungal,Therapeutic Fungicides,Agent, Antifungal,Anti Fungal Agents,Antifungal Antibiotics
D015821 Eye Infections, Fungal Infection by a variety of fungi, usually through four possible mechanisms: superficial infection producing conjunctivitis, keratitis, or lacrimal obstruction; extension of infection from neighboring structures - skin, paranasal sinuses, nasopharynx; direct introduction during surgery or accidental penetrating trauma; or via the blood or lymphatic routes in patients with underlying mycoses. Mycosis, Ocular,Mycotic Infections, Ocular,Ocular Infections, Fungal,Oculomycosis,Fungal Eye Infections,Eye Infection, Fungal,Fungal Eye Infection,Fungal Ocular Infection,Fungal Ocular Infections,Infection, Fungal Eye,Infection, Fungal Ocular,Infection, Ocular Mycotic,Infections, Fungal Eye,Infections, Fungal Ocular,Infections, Ocular Mycotic,Mycoses, Ocular,Mycotic Infection, Ocular,Ocular Infection, Fungal,Ocular Mycoses,Ocular Mycosis,Ocular Mycotic Infection,Ocular Mycotic Infections,Oculomycoses
D015948 Keratoplasty, Penetrating Partial or total replacement of all layers of a central portion of the cornea. Keratoplasties, Penetrating,Penetrating Keratoplasties,Penetrating Keratoplasty

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