Shirvani M. et al., 2019: Unilateral endogenous Candida endophthalmitis after extracorporeal shock wave lithotripsy for a renal stone in an immunocompetent woman: a case report
Shirvani M, Hosseini S, Maalhagh M, Afarid M, Mirza-Khanlooi A, Mohaghegh S.
Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz University of Medical Sciences, Shiraz, Iran.
PURPOSE: To report a case of endogenous Candida endophthalmitis that may cause catastrophic sight-threatening outcomes, after extracorporeal shock wave lithotripsy (ESWL) in a healthy woman. CASE PRESENTATION: A 32-year-old woman presented to the ophthalmology clinic with the symptom of blurred vision and floater in her right eye. She underwent ESWL for renal stone 1 week prior to her presentation. Fundus examination showed an elevated white lesion in para-fovea with fluffy border. Smear of diagnostic vitreous sampling showed pseudo-hypha and budding yeast. Systemic and immunologic and infectious workups were unremarkable. In our case, response to intravitreal and intravenous injection of amphotericin-B and oral fluconazole was dramatic. Six weeks after starting the treatment, infiltrative lesion completely disappeared. The authors review previous MEDLINE literature about this topic. CONCLUSION: Endogenous Candida endophthalmitis following renal stone lithotripsy is a serious and rare intraocular infection that may happen in healthy individuals without any risk factors.
J Ophthalmic Inflamm Infect. 2019 Feb 20;9(1):5. doi: 10.1186/s12348-019-0172-0. FREE ARTICLE
This is an extremely rare complication. Of five cases reported in the literature in 2006, 2015 and 3 in 2017, 4 had a proven fungal infection before ESWL treatment.