Endogenous Cryptococcal Endophthalmitis in Immunocompetent Host: Case Report and Review of Multimodal Imaging Findings and Treatment. (19th May 2018)

• Record Type: Journal Article
• Authors: Amphornphruet, Atchara; Silpa-archa, Sukhum; Preble, Janine M.; Foster, C. Stephen
• Is Part Of: Ocular immunology and inflammation. Volume 26:Number 4(2018)
• Page Start: 518
• Page End: 522
• Publication Date: 2018-05-19
• Subjects: Cryptococcal infection -- endophthalmitis -- multimodal imaging; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2017.1298820
• Languages: English
• ISSNs: 0927-3948

Abstract

Abstract: Purpose : To describe a case of bilateral endogenous cryptococcal endophthalmitis in an immunocompetent host and to review adjunctive ophthalmic imaging patterns and treatment. Methods : A retrospective case report. Results : A 45-year-old female patient with two distinct presentations of endogenous cryptococcal endophthalmitis in each eye presented initially with progressive blurred vision in the left eye, beginning more than 10 years after a craniotomy with ventriculoperitoneal shunt. Complete ophthalmic imaging was conducted and compared with data from previous literature. Administration of amphotericin-B had poorly responded; however, consolidation of fluconazole resulted in disease stabilization. Conclusions : Bilateral intraocular cryptococcal infection can present with two distinct patterns of posterior segment findings. A review of ophthalmic imaging patterns found consistency in some characteristics of A-scan ultrasonogram and fundus fluorescein angiogram. Besides conventional treatment, voriconazole is likely to play an important role in the management of cryptococcal endophthalmitis.