Candidal Retinitis in a Gynecologic Patient

• Type of Material: Article
• Authors: Pleas R. Gopas, Emory University; Cyril O. Spann, Emory University; Jennifer I. Lim, Emory University; Ira Horowitz, Emory University
• Language: English
• Date: 1995-01-01
• Publisher: Hindawi Publishing Corporation
• Publication Version: Final Published Version
• Copyright Statement: (C) 1995 Wiley-Liss, Inc.ing Corporation.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1155/S106474499500007X
• Title of Journal or Parent Work: Infectious Diseases in Obstetrics and Gynecology
• ISSN: 1064-7449
• Volume: 2
• Issue: 5
• Start Page: 228
• End Page: 230
• Keywords: sepsis; Candida albicans; candidemia
• Research Categories: Health Sciences, Opthamology; Health Sciences, General; Health Sciences, Obstetrics and Gynecology

Abstract

Background: Candidal retinitis is a rare but potentially devastating infection in the postoperative patient. Due to the possibility of blindness if the diagnosis and treatment are delayed, we present this report to help educate gynecologic surgeons. Case: A postmenopausal patient presented for the treatment of ovarian carcinoma. Her surgical therapy required radical tumor debulking with partial bowel resection. The patient was begun on intravenous (IV) hyperalimentation through a central venous catheter. On the 7th postoperative day, a cephalosporin antibiotic was administered. Because of persistent fever, a septic workup was instituted and revealed an infected central venous catheter that was culture positive for Candida albicans. The patient complained of visual disturbances and an ophthalmological examination revealed candidal retinitis. Amphotericin B and fluconazole were administered with resolution of her fever and visual changes. Conclusion: The risk factors of malignancy, abdominopelvic surgery, antibiotic therapy, and IV catheters are discussed. In view of the common association of these iatrogenic factors in gynecologic and obstetrical practice, we present this case to help make physicians aware of this potentially devastating infection.