| Presentation preference | Oral presentation |
| Title | Endogenous Endophthalmitis in an Immunosuppressed Patient Masquerading as Intermediate Uveitis |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To report the diagnostic course of a patient initially suspected of having intermediate uveitis of unclear etiology, ultimately diagnosed with endogenous endophthalmitis due to Candida albicans. |
| Methods | Case report |
| Results | A 60-year-old female with a history of breast cancer under chemotherapy was initially referred with suspected intermediate uveitis in 2022. Slit-lamp examination revealed vitreous cells, as well as anterior chamber cells, while fluorescein/indocyanine green angiography showed only a hot disc. Laboratory findings were unremarkable. Initial treatment with oral steroids resulted in significant improvement. Upon recurrence in 2024 with now manifest papillitis, steroid therapy was initially again effective. Differential diagnoses included uveitis and papillitis associated with CDK inhibitor therapy. However, following the development of a new hypopyon, a diagnostic pars plana vitrectomy was performed. Vitrectomy revealed Candida albicans, confirming endogenous endophthalmitis. The patient was admitted for systemic antifungal treatment with fluconazole. Despite therapy, the course was complicated by a rhegmatogenous retinal detachment requiring silicone oil tamponade. The underlying cause of the endogenous endophthalmitis remained unclear, with no systemic source of Candida identified. |
| Conclusion | This case highlights the diagnostic complexity of recurrent intermediate uveitis in the context of systemic malignancy and immunosuppression. Early consideration of infectious etiologies, even in the absence of systemic evidence, is crucial. Endogenous Candida endophthalmitis in immunosuppressed patients can masquerade as uveitis and requires timely intervention to prevent severe ocular complications. |
| Conflict of interest | No |
1
| Last name | FROESE |
| Initials of first name(s) | K |
| Department | Department of Ophthalmology, Stadtspital Zuerich, Triemli |
| City | Zuerich |
| Country | Switzerland |
2
| Last name | Cazana |
| Initials of first name(s) | IM |
| Department | Department of Ophthalmology, Stadtspital Zuerich, Triemli |
| City | Zuerich |
| Country | Switzerland |
3
| Last name | Becker |
| Initials of first name(s) | MD |
| Department | Department of Ophthalmology, Stadtspital Zuerich, Triemli |
| City | Zuerich |
| Country | Switzerland |
