BILATERAL CANDIDA ENDOPHTHALMITIS IN 2 IV DRUG-ABUSERS RECEIVING ORALL-METHADONE SUBSTITUTION THERAPY

Background Controlled therapy programms for former i.v. heroin abusers supervised by physicians offer levomethadone (L-Polamidon(R)) as an o ral substitute for heroin to allow social stabilisation of the addict. As well they reduce the risk of bloodborne infections (e.g. HIV and h epatitis) by giving up ''needle sharing''. Assuming that i.v. drug abu se is one of the major risk factors for Candida endophthalmitis in you ng, otherwise healthy patients, in case of strict oral substitution no onset of Candida endophthalmitis should be expected. Case report The clinical courses of two HIV-negativ and primarily i.v. heroin addicted young male white patients are presented. While participating in an ex clusively controlled, oral program of methadone substitution for sever al months, both patients developed bilateral Candida endophthalmitis. Conclusion A persisting i.v. abuse, either of heroin or of L-methadone , parallel to the supposingly strict orally applied substituting drug L-methadone has definitely to be suspected leading to the Candida endo phthalmitis.