J Korean Ophthalmol Soc > Volume 59(3); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(3):282-287.
DOI: https://doi.org/10.3341/jkos.2018.59.3.282    Published online March 15, 2018.
A Case of Fungal Endophthalmitis after Having Received Extraction of Wisdom Tooth in Healthy Woman.
Minwoo Lee, Eun Young Choi, Sung Chul Lee, Min Kim
1The Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. Minkim76@gmail.com
2The Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
내과적 과거력이 없는 건강한 환자에서 사랑니 발치 후 발생한 칸디다 안내염의 증례보고
이민우1⋅최은영1⋅이성철2⋅김 민1
연세대학교 의과대학 강남세브란스병원 안과학교실 시기능개발연구소1, 연세대학교 의과대학 세브란스병원 안과학교실 시기능개발연구소2
Correspondence:  Min Kim,
Email: Minkim76@gmail.com
Received: 19 October 2017   • Revised: 13 December 2017   • Accepted: 20 February 2018
Abstract
PURPOSE
To report a case of candida endogenous endophthalmitis in healthy women who had received extraction of wisdom tooth. CASE SUMMARY: A 65-year-old medically healthy woman who had received extraction of wisdom tooth two weeks ago, presented with floater symptoms in her left eye. Best-corrected visual acuity was 20/40 and intraocular pressure was 17 mmHg in her left eye. Inflammatory cells were found in the anterior chamber and vitreous. Fluorescein angiography showed multiple hypofluorescence without vascular leakage. With provisional diagnosis of intermediate uveitis, she was prescribed oral steroid for two weeks. After that, inflammatory cells in anterior chamber was reduced but vitreous imflammatory cell was increased and fundus examination detected newly developed infiltrated lesion at superotemporal area. The patient was presumed to have fungal endophthalmitis and immediate intravitreal voriconazole injection was performed. Three days after intravitreal voriconazole injection, diagnostic vitrectomy and intravitreal voriconazole injection were performed. Vitreous cultures revealed the growth of Candida albicans. Despite the treatment, inflammatory response in anterior chamber and vitreous rapidly increased and visual acuity was decreased to hand movement. We changed anti-fungal agent, voriconazole to Amphotericin B. Additional three-time intravitreal injection was done and therapeutic vitrectomy with oil injection were performed. After treatment, the patient's fundus markedly improved and inflammatory response was decreased. CONCLUSIONS: This case report shows candida endophthalmitis in healthy woman who had received extraction of wisdom tooth. So to diagnose endophthalmitis, patient's medical history should carefully be checked including dental care history who presented with vitreous inflammation and inflammatory infiltrated lesion at fundus.
Key Words: Candida endophthalmitis;Diagnostic vitrectomy;Endogenous endophthalmitis


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