Fluconazole in the management of endophthalmitis in disseminated candidosis of heroin addicts

Abstract

Seven heroin addicts were treated with fluconazole for endophthalmitis. All the patients had cutaneous lesions: deep-seated scalp nodules and/or pustulosis in hairy zones. One patient had an abscess at the venipuncture site. Candida albicans was isolated from all the extraocular sites in all the patients. Five patients were treated with 400 mg of intravenous 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 the first day, followed by 200 mg daily for three consecutive weeks). Tolerance to fluconazole was good and it was not necessary to stop treatment for any patient. All the cutaneous lesions stabilized and healed. The eye lesions cleared completely in all cases, except in one patient in whom vitrectomy was indicated, and in whom there was a poor response to the exclusive treatment with fluconazole and associated corticosteroids.