Refractory Candida dubliniensis Retinitis in an Immunocompetent Patient

ABSTRACT

Background

Fungal endophthalmitis is an intraocular infection that rarely develops in immunocompetent individuals.

Case

A 35-year-old healthy, immunocompetent male presented with a 1-week history of pain and redness in the left eye. Visual acuity was 20/50. Dilated fundus examination revealed focal chorioretinitis in the posterior pole with associated vitritis, suspicious for a fungal etiology. He was started empirically on oral voriconazole and valacyclovir. A comprehensive systemic workup returned negative. Inflammation worsened and a diagnostic vitrectomy was performed which revealed Candida dubliniensis. The dose of oral voriconazole was increased, and intravitreal voriconazole and amphotericin B injections were added for refractory disease. Treatment response was gauged by fungal pillar height on optical coherence tomography. Eight months of oral voriconazole and 68 intravitreal antifungal injections were required to achieve complete regression and a final visual acuity of 20/20.

Conclusion

Candida dubliniensis endophthalmitis can affect immunocompetent individuals and require a prolonged treatment course.

KEYWORDS:

• Candida dubliniensis retinitis
• Candida retinitis
• fungal retinitis
• refractory retinitis
• fungal endophthalmitis
• endophthalmitis

Disclosure statement

The authors have no conflicts of interest to disclose.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.