Postoperative endophthalmitis secondary to Candida parapsilosis. A case treated by vitrectomy and intravitreous therapy.

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.