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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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