Multiresistant Candida Endophthalmitis Treated with Intravitreal Caspofungin: A Case Report

Ocul Immunol Inflamm. 2024 Aug;32(6):858-862. doi: 10.1080/09273948.2023.2168701. Epub 2023 Jan 25.

Abstract

Background: Candida endophthalmitis is a severe complication of candidemia. Currently, the recommended treatment of fungal endophthalmitis is a combination of intravitreal and systemic antifungal drugs, and in some cases vitrectomy is also required. Intravitreal therapies that are commonly used are amphotericin B and voriconazole, although recently the use of intravitreal caspofungin has been described in a few case reports. However, clinical experience with intravitreal caspofungin is still limited.

Case presentation: We report a case of bilateral candida tropicalis endophthalmitis, initially managed with repeated 100 μg/0.1 ml caspofungin intravitreal injections and posteriorly treated with pars plana vitrectomy in both eyes.

Conclusions: Intravitreal caspofungin could be a safe intravitreal alternative to habitual antimycotic drugs in cases with resistant candida endophthalmitis.Abbreviations: Intensive Care Unit (ICU); Best-Corrected Visual Acuity (BCVA).

Keywords: Candida; case report; caspofungin; endophthalmitis; intravitreal.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents* / administration & dosage
  • Antifungal Agents* / therapeutic use
  • Candida tropicalis / isolation & purification
  • Candidiasis* / diagnosis
  • Candidiasis* / drug therapy
  • Candidiasis* / microbiology
  • Caspofungin* / therapeutic use
  • Drug Resistance, Multiple, Fungal
  • Endophthalmitis* / diagnosis
  • Endophthalmitis* / drug therapy
  • Endophthalmitis* / microbiology
  • Eye Infections, Fungal* / diagnosis
  • Eye Infections, Fungal* / drug therapy
  • Eye Infections, Fungal* / microbiology
  • Humans
  • Intravitreal Injections*
  • Visual Acuity
  • Vitrectomy

Substances

  • Antifungal Agents
  • Caspofungin