Torulopsis candida (Candida famata) endophthalmitis simulating Propionibacterium acnes syndrome
N. A. Rao, A. V. Nerenberg and D. J. Forster
A. Ray Irvine, Jr, Eye Pathology Laboratory, Doheny Eye Institute, Los Angeles, CA 90033.
Four months after undergoing extracapsular cataract extraction with
implantation of a posterior chamber intraocular lens, a 74-year-old woman
developed granulomatous anterior uveitis. Although she initially responded
well to corticosteroid therapy, she experienced multiple recurrences on
discontinuation of this therapy. Slit-lamp examination showed the ocular
inflammation to be associated with white cortical material within the lens
capsular sac. She underwent removal of the implant as well as the lens
capsular sac. Anaerobic culture yielded no organisms, but fungus cultures
yielded Torulopsis candida. Histopathologic and electron microscopic
studies showed large numbers of yeast sequestered within the lens capsular
sac and mild granulomatous inflammation around the sac. Torulopsis candida
is occasionally isolated from specimens as a contaminant, but has not yet
been shown to produce human disease. The case reported herein documents
potential pathogenicity of Torulopsis candida and reveals the importance of
organisms other than anaerobic bacteria in causing delayed and localized
intraocular inflammation that is virtually identical to Propionibacterium
acnes infection.
