Management of presumed candida endophthalmitis during the COVID-19 pandemic: Case report and review of the literature

Eur J Ophthalmol. 2023 May;33(3):NP136-NP140. doi: 10.1177/11206721221092190. Epub 2022 Apr 4.

Abstract

Purpose: To report the management of a case of candida endophthalmitis following intubation for SARS-CoV-2 ARDS, during the first lockdown, underlining consequently the limited access to the gold standard of care.

Methods: Case report.

Results: We have described the case of a 56-year-old Hispanic man who developed bilateral Candida endophthalmitis after one month of hospitalization in the intensive care unit for severe SARS-CoV-2 pneumonia. Multimodal imaging was obtained. Full serological screening for infection was done resulting negative. A diagnostic vitrectomy was impossible due to the limited access at the surgery room. Diagnosis of presumed candida endophthalmitis was made, according to a highly qualified center, and therapy with intravenous liposomal amphotericin B was administered. At three months, we observed lack of vitreous opacities and atrophic scars with no active lesions.

Conclusions: Diagnosis of candida endophthalmitis was a challenge in this pandemic scenario, given the impossibility of performing a diagnostic vitrectomy. Therefore, it was mainly based on patient's clinical manifestations, multimodal imaging and on unanimity of collegiality between our hospital and the highly specialized center.

Keywords: COVID-19; candida; endophthalmitis; uveitis.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • COVID-19*
  • Candida
  • Candidiasis* / diagnosis
  • Candidiasis* / drug therapy
  • Communicable Disease Control
  • Endophthalmitis* / diagnosis
  • Endophthalmitis* / drug therapy
  • Eye Infections, Fungal* / diagnosis
  • Eye Infections, Fungal* / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • SARS-CoV-2
  • Vitrectomy / adverse effects

Substances

  • Antifungal Agents