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Arquivos Brasileiros de Oftalmologia
On-line version ISSN 1678-2925
GODOY, Glaucio de; WAHAB, Sâmia Ali; LIMA, Ana Luísa Höfling de and MOREIRA, Hamilton. Candida albicans endophthalmitis following penetrating corneal graft: case report. Arq. Bras. Oftalmol. [online]. 2004, vol.67, n.2, pp. 349-352. ISSN 1678-2925. http://dx.doi.org/10.1590/S0004-27492004000200030.
The authors report a case of a patient submitted to penetrating corneal graft for keratoconus with an exaggerated inflammatory response during the postoperative period. The patient was suspected of having an atypical rejection to the donor button. There were periods of improvement, followed by periods of worsening of the inflammation at each attempt of reducing the topical corticosteroid. After initiating immunosuppressive therapy with cyclosporin and high doses of topical corticosteroid, the patient developed Candida albicans endophthalmitis affecting the anterior segment of the eye and the vitreous body, but sparing the chorioretina. The patient improved after three injections of 5 µg intravitreal amphotericin B, 400 mg oral ketoconazole daily and topical clotrimazole every four hours. The authors also discuss the main possibilities of contamination of the patient, the infectious picture probably being related to the surgical procedure.
Keywords : Endophthalmitis [drug therapy]; Eye infections, fungal; Candida albicans; Keratoplasty, penetrating; Cyclosporine [therapeutic use]; Candidiasis.