Successful treatment of fungal endophthalmitis using intravitreal caspofungin.

Ciprian Danielescu, Alina Cantemir, Dorin Chiselita

Arquivos brasileiros de oftalmologia 2017 Jun

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Fungal endophthalmitis is a rare condition often associated with poor prognosis. We present a case of postoperative acute fungal endophthalmitis caused by the yeast-like fungus Stephanoascus ciferrii (Candida ciferrii). The fungus was resistant to fluconazole, voriconazole, and amphotericin B but susceptible to caspofungin. Because the degree of vitreal penetration of caspofungin after its intravenous administration is unclear, we performed multiple intravitreal injections, first with 50 µg/0.1 ml and then with 250 µg/0.1 ml caspofungin. Despite the recurrence of symptoms, intravitreal injection of caspofungin finally abolished the inflammation and achieved ambulatory vision that persisted until 1 year of follow-up. To our knowledge, this is the first report of S. ciferrii endophthalmitis and its successful treatment with intravitreal caspofungin.

Citation

Ciprian Danielescu, Alina Cantemir, Dorin Chiselita. Successful treatment of fungal endophthalmitis using intravitreal caspofungin. Arquivos brasileiros de oftalmologia. 2017 Jun;80(3):196-198