FLUCONAZOLE IN THE MANAGEMENT OF ENDOPHTHALMITIS IN DISSEMINATED CANDIDOSIS OF HEROIN-ADDICTS

Seven heroin addicts were treated with fluconazole for endophthalmitis . All the patients had cutaneous lesions: deep-seated scalp nodules an d/or pustulosis in hairy zones. One patient had an abscess at the veni puncture site. Candida albicans was isolated from all the extraocular sites in all the patients. Five patients were treated with 400 mg of i ntravenous fluconazole on the first day, followed by 200 mg (i.v.) for one week and finally 200 mg daily orally for a further two weeks. Two patients were treated exclusively with oral fluconazole (400 mg on th e first day, followed by 200 mg daily for three consecutive weeks). To lerance to fluconazole was good and it was not necessary to stop treat ment for any patient. All the cutaneous lesions stabilized and healed. The eye lesions cleared completely in all cases, except in one patien t in whom vitrectomy was indicated, and in whom there was a poor respo nse to the exclusive treatment with fluconazole and associated cortico steroids.