Endogenous fungal endophthalmitis: eight-year experience at a tertiary referral center

Endogenous fungal endophthalmitis is a complex ocular condition resulting from fungal seeding in the bloodstream and is associated with many predisposing risk factors, particularly intravenous drug abuse. Candida albicans is a pathogenic yeast responsible for causing endogenous fungal endophthalmitis. Candida organisms seed the choroid and retina of an infected individual forming vision-threatening lesions; with disease progression the organisms propagate the vitreous cavity. The initial signs of infection are not obvious to most patients causing a delayed diagnosis. Delayed diagnosis of endogenous fungal endophthalmitis increases morbidity and complicates clinical treatment. The prognosis of endogenous fungal endophthalmitis is dependent upon the fungal species, level of intraocular involvement, and the timing of interventions. Reporting a history of intravenous drug use is vital when presenting for ophthalmic evaluation. Physicians must to rely on a variety of tools in order to make a proper diagnosis. Patients must also be educated about the manifestations of endogenous fungal endophthalmitis. Although the IDSA guidelines are a standard clinical tool for diagnosis and treatment, the physician should evaluate every case in to determine the proper course of treatment. Antifungal resistance is an emerging health issue. Antifungal resistance is similar in nature to antibiotic resistance; it is prevalent in tertiary centers where complicated medical care is necessitated often with indwelling medical devices. Fluconazole resistant cases of Candida infections are increasing. The public health concerns with endogenous fungal endophthalmitis are poor prognosis, antifungal resistance, susceptible population, and intravenous drug use