Presumed bilateral endogenous Cryptococcus neoformans endophthalmitis with concomitant Toxoplasma gondii retinochoroiditis

Q3 Medicine

American Journal of Ophthalmology Case Reports Pub Date : 2025-06-11 DOI:10.1016/j.ajoc.2025.102364

Shane Griffin , Neeraj Chawla , Lawrence Chan , Anita Agarwal , Gaurav Shah

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引用次数: 0

Abstract

Purpose

To report a case of bilateral endogenous Cryptococcus endophthalmitis with Toxoplasma retinochoroiditis.

Observations

A 57-year-old woman with history of renal transplantation developed Cryptococcus neoformans fungemia and meningitis. Reporting bilateral blurry vision, she was found to have associated bilateral endophthalmitis suspicious for endogenous cryptococcal endophthalmitis that was initially responsive to intravitreal voriconazole injections but subsequently worsened despite systemic and intraocular anti-fungal treatments. Given her refractory disease, additional testing was performed, which revealed added infection with Toxoplasma gondii. She underwent bilateral vitrectomy with povidone-iodine infusion and systemic parasiticidal treatment with improvement and stability of her condition.

Conclusions and importance

Immunocompromised hosts are at risk for infection with multiple opportunistic infections that may require broad testing and aggressive medical and surgical therapies.

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推测为双侧内源性新型隐球菌性眼内炎并伴有刚地弓形虫视网膜脉络膜炎

目的报告1例双侧内源性隐球菌性眼内炎合并视网膜脉络膜弓形虫性炎。观察1例57岁女性，有肾移植史，并发新型隐球菌真菌血症和脑膜炎。报告双侧视力模糊，发现伴有双侧眼内炎，怀疑为内源性隐球菌性眼内炎，最初对玻璃体内注射伏立康唑有反应，但经全身和眼内抗真菌治疗后病情恶化。鉴于她的难治性疾病，进行了额外的检测，结果显示她又感染了刚地弓形虫。患者接受双侧玻璃体切除加聚维酮碘输注及全身除寄生治疗，病情改善及稳定。结论和重要性免疫功能低下的宿主存在多种机会性感染的感染风险，可能需要广泛的检测和积极的药物和手术治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology Case Reports Medicine-Ophthalmology

CiteScore

2.40

自引率

0.00%

发文量

513

审稿时长

16 weeks

期刊介绍： The American Journal of Ophthalmology Case Reports is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished case report manuscripts directed to ophthalmologists and visual science specialists. The cases shall be challenging and stimulating but shall also be presented in an educational format to engage the readers as if they are working alongside with the caring clinician scientists to manage the patients. Submissions shall be clear, concise, and well-documented reports. Brief reports and case series submissions on specific themes are also very welcome.