Ocular Fluconazole Treatment of Candida parapsilosis Endophthalmitis After Failed Intravitreal Amphotericin B

Candida parapsilosis is a well-described causative agent for the delayed onset of postoperative endophthalmitis. 1 We present a case demonstrating successful treatment of chronic postsurgical C parapsilosis with oral fluconazole after the proven failure of intravitreal amphotericin B and systemic ketoconazole. Report of a Case. A 79-year-old woman presented with a 2-month history of inflammation and decreased vision in her left eye. She had undergone extracapsular cataract extraction with posterior capsular rupture and vitreous loss in the left eye 6 months earlier. A limited anterior vitrectomy with anterior chamber lens implantation was done primarily, and the patient recovered visual acuity of 20/60. The patient had been treated with periocular depot and topical steroids for 4 weeks prior to referral. On examination, visual acuity was 20/400 OS. The results of a biomicroscopic examination revealed 3+ inflammatory cells in the anterior chamber, large keratic precipitates, dense vitreous inflammation, and fragments of