Hematogenous Candida Endophthalmitis — A Complication of Candidemia

Six patients with candidemia and candida endophthalmitis had received systemic antibiotics and had prolonged indwelling intravenous catheters. Symptoms, which began three to 15 days after the positive blood cultures for candida, included blurring of vision, spots before the eye and pain in or around the eye. In two cases lesions were found in the absence of symptoms. Frank intravitreous extension occurred in three, and an anterior uveitis in the other three patients. The administration of amphotericin B (one patient also received 5-fluorocytosine) resulted in healing of the lesions and improvement in visual acuity in five cases. The management of patients with candidemia should include careful attention to ocular complaints and repeated ophthalmoscopic examinations. On detection of the typical lesions, therapy with systemic amphotericin B is indicated.