Management of presumed candida endophthalmitis during the COVID-19 pandemic: Case report and review of the literature. Issue 3 (May 2023)

• Record Type: Journal Article
• Authors: Fossataro, Federica; Martines, Francesco; Neri, Piergiorgio; Allegri, Pia; Pece, Alfredo
• Is Part Of: European journal of ophthalmology. Volume 33:Issue 3(2023)
• Page Start: NP136
• Page End: NP140
• Publication Date: 2023-05
• Subjects: COVID-19 -- uveitis -- candida -- endophthalmitis; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.1177/11206721221092190
• Languages: English
• ISSNs: 1120-6721

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.