amphotericin-b and Panophthalmitis

Topics: Adult; Amphotericin B; Antifungal Agents; Candida; Candidiasis; Eye; Humans; Intravitreal Injections; Magnetic Resonance Imaging; Male; Panophthalmitis; Tomography, X-Ray Computed; Vision Disorders

A severe case of Candida albicans panophthalmitis, probably prompted by an underlying diabetes mellitus, is reported. The course was prolonged (more than 16 weeks), although favourable after treatment with several antifungal agents, all with a predictable activity in this ocular complication and with proven susceptibility in the present case: fluconazole, liposomal amphotericin B, caspofungin, and voriconazole.

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Caspofungin; Echinocandins; Fluconazole; Humans; Lipopeptides; Male; Middle Aged; Panophthalmitis; Peptides, Cyclic; Pyrimidines; Triazoles; Voriconazole

Topics: Aged; Amphotericin B; Gas Gangrene; Humans; Male; Mucormycosis; Orbit; Orbital Diseases; Panophthalmitis

Over a two-year period 8 patients were hospitalized with a presumptive diagnosis of Candida endophthalmitis. 6 patients were heroin addicts, while in the 2 other patients no risk factor could be identified. The presumptive diagnosis was based on the typical findings of retinohyalitic exudate and exclusion of other factors causing endophthalmitis. Intravenous therapy with amphotericin-B and flucytosin resulted in definitive scar healing. In 1 patient vitrectomy was necessitated by recurrence of endophthalmitis resistant to antifungal therapy.

Topics: Adolescent; Adult; Amphotericin B; Candidiasis; Drug Therapy, Combination; Female; Flucytosine; Heroin Dependence; Humans; Male; Panophthalmitis

A 30-year-old man developed endophthalmitis three weeks after an intravenous injection of hydromorphone hydrochloride. Penicillium species was recovered from a vitreous aspirate. Treatment with amphotericin B and flucytosine resulted in documented sterilization of the vitreous. At a six-month follow-up examination, the visual acuity of the involved eye was still limited to light perception.

Topics: Adult; Amphotericin B; Antifungal Agents; Humans; Injections, Intravenous; Male; Mycoses; Panophthalmitis; Penicillium; Prednisone; Substance-Related Disorders

A 79-year-old woman developed Candida parapsilosis endophthalmitis nine weeks after an uneventful cataract extraction. The diagnosis was suspected on clinical examination and documented by culture of the vitreous biopsy obtained during vitrectomy. The endophthalmitis was treated by pars plana vitrectomy and intravitreous injection of amphotericin B and dexamethasone. The patient was also treated with systemic flucytosine, to which the operative isolate proved resistant. This was therefore immediately discontinued; however, the intraocular infection cleared rapidly after the initial vitrectomy and intravitreous injection. The patient's visual acuity ultimately returned to 20/20. The combination of these two newer methods of treatment for fungal endophthalmitis achieved a favorable outcome in a disease process that has often previously wrought disaster.

Topics: Aged; Amphotericin B; Candidiasis; Cataract Extraction; Cephaloridine; Dexamethasone; Drug Therapy, Combination; Female; Gentamicins; Humans; Panophthalmitis; Postoperative Complications; Vitreous Body

Topics: Adolescent; Amphotericin B; Candidiasis; Eye; Flucytosine; Humans; Imidazoles; Injections; Injections, Intravenous; Male; Panophthalmitis; Trityl Compounds