Candida endophthalmitis after intravenous drug abuse
G. L. Aguilar, M. S. Blumenkrantz, P. R. Egbert and J. P. McCulley
Patients with endogenous Candida endophthalmitis associated with
intravenous (IV) drug abuse may manifest ocular and systemic signs
different from those seen in other forms of endogenous Candida
endophthalmitis. There may be a sparcity of evidence of systemic
candidiasis, including negative serology and normal physical examination
results. Anterior uveitis and extensive vitreous involvement are common and
do not necessarily have associated typical retinal lesions, which are more
commonly seen in the compromised host. This may occur either because of the
more transitory nature of choroidal or retinal lesions or because these
patients often seek treatment at later stages. Even with a typical clinical
picture, it is difficult to get culture confirmation of the diagnosis.
Material obtained by vitrectomy must be concentrated before inoculation of
media because of the known difficulty of culturing Candida from the
vitreous cavity.
