Bilateral endogenous Candida albicans endophthalmitis following COVID‐19 infection and intravenous antibiotics use: A case report

Abstract

Key Clinical MessageEndogenous fungal endophthalmitis tends to occur in immunocompromised patients, including COVID‐19 infection. For high‐risk populations, timely tissue biopsy, fungal culture, and susceptibility testing can facilitate early diagnosis and treatment, thereby improving the prognosis.AbstractWhile endogenous fungal endophthalmitis is a rare condition, its incidence has recently been on the rise. A 48‐year‐old male presented with complaints of acute visual loss in his right eye for 2 weeks. He had a history of COVID‐19 infection, confirmed by a positive nucleic acid test, and was treated with intravenous antibiotics and glucocorticoids a week before the episode. A comprehensive eye examination revealed significant inflammatory cells floating in the anterior chamber and considerable cloudiness in the vitreous of the right eye, while few vitreous cells were visualized in the left eye. After pars plana vitrectomy (PPV) was performed in the right eye, a vitreous biopsy revealed an intravitreal infection of Candida albicans, which was susceptible to fluconazole. Endogenous fungal endophthalmitis occurs in patients with various underlying systemic conditions, such as those with diabetes, organ transplantation recipients, individuals undergoing chemotherapy, users of corticosteroids and immunosuppressants, AIDS patients, and those engaged in intravenous drug use. In high‐risk populations associated with intravenous antibiotics, the timely identification of one or more well‐defined oval yellow‐white chorioretinal lesions, especially in the posterior pole of the retina, can contribute to an early diagnosis through tissue biopsy, fungal culture, and susceptibility testing. This approach enables targeted antifungal therapy, thereby improving the prognosis of visual function for the patient.