Purchase this article with an account.
K Keyhani, P Latkany, S Kehdar, CM Samson, M Shah; Pseudo-Apparent Candidal Endophthalmitis (PACE) Syndrome . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4451.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To demonstrate that clinical examination and history are insufficient to make a presumptive diagnosis of candidal endophthalmitis. Apparent candidal endophthalmitis should not be treated without a confirmatory biopsy. Methods: Clinical examination, history, fundus photography, pars plana vitrectomy, and laboratory microbiologic analysis of one patient compared to a series of patients with confirmed candidal endophthalmitis. Results: A 23 year old woman with a recent history of spontaneous abortion with subsequent dilation and curetage was hospitalized for severe anemia, depression, failure to thrive, and bulimia. In addition, the patient recently had indwelling intravenous catheters for parenteral nutrition discontinued. She had developed an indolent pattern of vision loss consistent with classic candidal endophthalmitis. Detailed examination showed a unilateral panuveitis with mild external injection. Identical clinically to patients with confirmed candidal endophthalmitis, there were vitreous snowballs and a fluffy mass originating from the peripapillary retina. As the patient could not be relied on to ingest oral fluconazole, she permitted a diagnostic vitrectomy. The undiluted vitreous specimen was positive for numerous Gram-positive and Gram variable acid fast negative organisms. Fungal stains were negative. She responded to an extended course of antibacterial agents. Conclusion: Endogenous bacterial endophthalmitis can mimic candidal endophthalmitis in every clinical aspect. Apparent candidal endophthalmitis should be confirmed by biopsy.
This PDF is available to Subscribers Only