ENDOGENOUS CRYPTOCOCCAL ENDOPHTHALMITIS

Background: Occurrence of cryptococcal endophthalmitis is rare and com monly is associated with widespread disseminated diseases. The authors report here a well-documented case of endogenous cryptococcal endopht halmitis without the preceding meningeal infection. Methods: A 45-year -old female with a history of long-term use of systemic corticosteroid and cytotoxic drugs for systemic lupus erythematosus suffered from pr ogressive visual loss in her left eye over 1 month. Large exudative re tinal detachment and severe vitreous infiltration were observed. Resul ts: Histopathologic study of the retinal biopsy specimen established t he diagnosis of cryptococcal endophthalmitis. Subsequent positive hist opathologic study of the aspiration vitreous smear and epiretinal memb rane confirmed the recurrence and persistence of the disease over 4 mo nths after the initial presentation, Systemic amphotericin B-fluconazo le and two doses of intravitreous amphotericin B injection eliminated the infection successfully. Conclusion: The authors report here a well -documented case of cryptococcal endophthalmitis and present the seria l clinical and histopathologic pictures. The importance of retinal bio psy in diagnosis and the combined form of antifungal treatment also ar e shown.