Sng Edwin Chong Yu, Tan Ai Ling, Zhou Peijun Yvonne, Tan Tira J, Waduthantri Samanthila, Chee Soon-Phaik, Tan Ban Hock
Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore.
Department of Infectious Diseases, Changi General Hospital, Singapore, Singapore.
Open Forum Infect Dis. 2021 Oct 8;8(12):ofab516. doi: 10.1093/ofid/ofab516. eCollection 2021 Dec.
endophthalmitis is a serious complication of candidemia. Diagnosis requires identification of ocular lesions on dilated fundoscopy, aided by isolation of the organism from blood and/or vitreous humor. However, the initial ophthalmological examination may be negative in some cases. Experience with isavuconazole for the treatment of endophthalmitis is limited. We present a case of a 65-year-old woman with metastatic breast cancer on chemotherapy who developed endophthalmitis with initial negative ophthalmological examination. She was treated with vitrectomy and 6 weeks of oral fluconazole. Despite vitrectomy and culture-directed antifungal treatment, management was complicated by lack of response to fluconazole and intolerance to other antifungals, necessitating the use of isavuconazole, which proved efficacious.
眼内炎是念珠菌血症的一种严重并发症。诊断需要在散瞳眼底检查时识别眼部病变，并通过从血液和/或玻璃体液中分离出病原体来辅助诊断。然而，在某些情况下，初次眼科检查可能为阴性。关于艾沙康唑治疗眼内炎的经验有限。我们报告一例65岁患有转移性乳腺癌且正在接受化疗的女性，她发生了眼内炎，初次眼科检查为阴性。她接受了玻璃体切除术并口服氟康唑6周。尽管进行了玻璃体切除术和针对培养结果的抗真菌治疗，但由于对氟康唑无反应且对其他抗真菌药物不耐受，治疗变得复杂，因此需要使用艾沙康唑，结果证明其有效。
