Treatment of bilateral candidal endophthalmitis with intravenous caspofungin.

Abstract

PURPOSE:

Fungal resistances to drugs are increasing. Caspofungin is a new antifungal agent effective in the treatment of invasive candidiasis. We report a case of candidal endophthalmitis that responded adequately to caspofungin.

METHODS:

A 24-year-old man with acute myeloid leukemia presented with vision loss in both eyes. Visual acuity was 20/50 in the right eye and counting fingers in the left eye. Fundus examination revealed multiple, premacular, vitreous, pearl stringshaped condensations in the right eye and a subretinal abscess in the left eye. Treatment with 50 mg of intravenous caspofungin once daily was started.

RESULTS:

After 1 month, inflammation in both eyes had decreased, although the left eye developed macular scarring. Medication at discharge was intravenous caspofungin once daily for another 6 weeks. Nine months after presentation, the patient had residual vitreous condensations in the premacular region of the right eye with visual acuity of 20/25 and severe macular scarring in the left eye with visual acuity of 20/100.

CONCLUSION:

This case adds support for the use of caspofungin as monotherapy for candidal endophthalmitis. Further studies are necessary to determine treatment options for the new antifungal agents.

• Authors: Inés Contreras, Carolina Arruabarrena, Marta S Figueroa
• Journal: Retinal cases & brief reports (Retin Cases Brief Rep) Vol. 1 Issue 3 Pg. 175-7 ( 2007) ISSN: 1935-1089 [Print] United States
• PMID: 25390788 (Publication Type: Journal Article)