Endogenous cryptococcal endophthalmitis

Abstract

We have described a case of Cryptococcus neoformans endophthalmitis, especially rare in the absence of simultaneous CNS involvement. The key to management appears to lie in early diagnosis, which is difficult because there are multiple causes of uveitis; clinical examination will not establish the specific cause. If clinical improvement is not apparent after several days of nonspecific therapy and other studies have failed to yield a diagnosis, appropriate stains and cultures of vitreal aspirate should be done for fungi and other organisms. Amphotericin B plus 5-fluorocytosine is the treatment of choice, possibly with intravitreal instillation of amphotericin B and vitrectomy.