Bilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection

Yusuke Arai,1 Yukihiro Sato,1 Atsushi Yoshida,1 Hidetoshi Kawashima,1 Toshikatsu Kaburaki,2 Harumi Gomi3 1Department of Ophthalmology, Jichi Medical University, Tochigi, Japan; 2Department of Ophthalmology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan; 3Cent...

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Autores principales:	Arai Y, Sato Y, Yoshida A, Kawashima H, Kaburaki T, Gomi H
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ee688fe79b3d4cb2918c08d52c5fc1ca
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spelling	oai:doaj.org-article:ee688fe79b3d4cb2918c08d52c5fc1ca2021-12-02T04:55:29ZBilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection1177-5483https://doaj.org/article/ee688fe79b3d4cb2918c08d52c5fc1ca2014-10-01T00:00:00Zhttp://www.dovepress.com/bilateral-endogenous-candida-albicans-subretinal-abscess-with-suspecte-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Yusuke Arai,1 Yukihiro Sato,1 Atsushi Yoshida,1 Hidetoshi Kawashima,1 Toshikatsu Kaburaki,2 Harumi Gomi3 1Department of Ophthalmology, Jichi Medical University, Tochigi, Japan; 2Department of Ophthalmology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan; 3Center for Clinical Infectious Diseases, Jichi Medical University, Tochigi, Japan Purpose: Candida albicans subretinal abscess is extremely rare. To our knowledge, only one unilateral case has been reported. Herein, we report one bilateral case. Mixed bacterial infection was also suspected based on broad-range real-time polymerase chain reaction.Methods: A 64-year-old man being treated with oral corticosteroids for interstitial pneumonia visited us for visual loss in the left eye. Best corrected visual acuity (BCVA) was 20/20 in the right eye and 8/200 in the left eye. Funduscopy revealed round yellowish-white subretinal lesions with retinal hemorrhage in both eyes.Results: Broad-range polymerase chain reaction of the vitreous fluid from the left eye showed a high copy count of bacterial 16s ribosome RNA. Despite large doses of antibiotics, the abscess expanded and vision decreased to light perception in the left eye. Exenteration of the left eye was performed followed by microscopic examination showing Gram-negative bacilli, and C. albicans was also cultured. Antibiotics and the maximum doses of antifungal drugs were administered. However, the abscess in the right eye expanded, and BCVA decreased to 2/200. Vitrectomy and silicone oil tamponade were performed. Vitreous fluid culture revealed C. albicans. At 16 months follow-up, BCVA was stable at 4/200 with healing of the subretinal abscess under silicone oil.Conclusion: Since C. albicans subretinal abscess is extremely rare and there was a concurrent mixed bacterial infection, diagnostic procedures in our bilateral case were more complicated than usual. C. albicans infection should be included in the differential diagnosis of subretinal abscesses. Keywords: Candida albicans, subretinal abscess, mixed infectionArai YSato YYoshida AKawashima HKaburaki TGomi HDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 2151-2154 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Arai Y Sato Y Yoshida A Kawashima H Kaburaki T Gomi H Bilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection
description	Yusuke Arai,1 Yukihiro Sato,1 Atsushi Yoshida,1 Hidetoshi Kawashima,1 Toshikatsu Kaburaki,2 Harumi Gomi3 1Department of Ophthalmology, Jichi Medical University, Tochigi, Japan; 2Department of Ophthalmology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan; 3Center for Clinical Infectious Diseases, Jichi Medical University, Tochigi, Japan Purpose: Candida albicans subretinal abscess is extremely rare. To our knowledge, only one unilateral case has been reported. Herein, we report one bilateral case. Mixed bacterial infection was also suspected based on broad-range real-time polymerase chain reaction.Methods: A 64-year-old man being treated with oral corticosteroids for interstitial pneumonia visited us for visual loss in the left eye. Best corrected visual acuity (BCVA) was 20/20 in the right eye and 8/200 in the left eye. Funduscopy revealed round yellowish-white subretinal lesions with retinal hemorrhage in both eyes.Results: Broad-range polymerase chain reaction of the vitreous fluid from the left eye showed a high copy count of bacterial 16s ribosome RNA. Despite large doses of antibiotics, the abscess expanded and vision decreased to light perception in the left eye. Exenteration of the left eye was performed followed by microscopic examination showing Gram-negative bacilli, and C. albicans was also cultured. Antibiotics and the maximum doses of antifungal drugs were administered. However, the abscess in the right eye expanded, and BCVA decreased to 2/200. Vitrectomy and silicone oil tamponade were performed. Vitreous fluid culture revealed C. albicans. At 16 months follow-up, BCVA was stable at 4/200 with healing of the subretinal abscess under silicone oil.Conclusion: Since C. albicans subretinal abscess is extremely rare and there was a concurrent mixed bacterial infection, diagnostic procedures in our bilateral case were more complicated than usual. C. albicans infection should be included in the differential diagnosis of subretinal abscesses. Keywords: Candida albicans, subretinal abscess, mixed infection
format	article
author	Arai Y Sato Y Yoshida A Kawashima H Kaburaki T Gomi H
author_facet	Arai Y Sato Y Yoshida A Kawashima H Kaburaki T Gomi H
author_sort	Arai Y
title	Bilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection
title_short	Bilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection
title_full	Bilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection
title_fullStr	Bilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection
title_full_unstemmed	Bilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection
title_sort	bilateral endogenous candida albicans subretinal abscess with suspected mixed bacterial infection
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/ee688fe79b3d4cb2918c08d52c5fc1ca
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_version_	1718401043986907136

Bilateral endogenous Candida albicans subretinal abscess with suspected mixed bacterial infection

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