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Blink
What Is This Month's Mystery Condition?
Written by Darin R. Goldman, MD, Robin A. Vora, MD, Caroline R. Baumal, MD, Tufts New England Eye Center, Boston.
Photo by Ryan Hulse, Tufts New England Eye Center, Boston.
 
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October 2012 Blink

Candida Albicans

A 20-year-old woman presented with floaters and worsening vision that she had experienced in her left eye for two weeks. She had recently had a spinal abscess due to methicillin-sensitive Staphylococcus aureus that had been treated with intravenous antibiotics via a peripherally inserted central catheter (PICC) line. She denied any history of intravenous drug abuse, though there was strong clinical suspicion otherwise.   

Vision in the affected eye was 20/70. Fundus examination was significant for 2+ vitritis and a fluffy white preretinal infiltrate nasal to the fovea. The appearance was highly suggestive of fungal endogenous endophthalmitis. A vitreous tap was performed, and voriconazole, vancomycin, and ceftazidime were injected. Vitreous cultures grew out Candida albicans.

The figure shows a color photograph of the infiltrate with a corresponding OCT map and B-scan section through the infiltrate. The last image reveals a preretinal and intraretinal hyperreflective lesion (arrow) with posterior shadowing (bracket). Inflammatory debris (arrowheads) is attached to the posterior hyaloid and is floating in the vitreous.

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