Background: Cryptococcus neoformans is an encapsulated yeast that can cause
fungemia and, in rare instances, lead to endogenous fungal
endophthalmitis. No standard of care has been established to treat fungal
endophthalmitis when systemic antifungal treatment fails to resolve the intraocular
infection. Intravitreal
voriconazole has been used for the treatment of fungal
endophthalmitis caused by a broad range of fungal pathogens, and a limited number of reports have shown the efficacy of using intravitreal
voriconazole for C neoformans
endophthalmitis. We report a case of endogenous fungal
endophthalmitis caused by C neoformans that was responsive to intravitreal
voriconazole. Case Report: A previously healthy 57-year-old male diagnosed with primary neuroendocrine lung
tumor developed endogenous
endophthalmitis from C neoformans. The
endophthalmitis was resistant to intravenous
amphotericin B treatment but was responsive to intravenous
fluconazole in one eye and was apparently more responsive to intravitreal
voriconazole in the other eye. Conclusion: Intravitreal
voriconazole should be considered for the treatment of cryptococcal
endophthalmitis.