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Case Reports: Rare disease
Cryptococcus laurentii endogenous endophthalmitis post COVID-19 infection
  1. Muthugaduru Jagadish Deepa1,
  2. Chitta Megharaj2,
  3. Santosh Patil3 and
  4. Padmaja Kumari Rani4
  1. 1Vitreo-Retina Services, Adarsh Super Speciality Eye Hospital, Shimoga, India
  2. 2Cataract and Refractive Services, Adarsh Super Speciality Eye Hospital, Shimoga, India
  3. 3Microbiology, Nanjappa Super Speciality Hospital, Shimoga, Karnataka, India
  4. 4Smt Kanuri Santhamma Centre for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Padmaja Kumari Rani; rpk111{at}gmail.com

Abstract

A man in mid-50s presented with progressive blurred vision in his left eye for over 6 weeks. He was a known diabetic with history of COVID-19 pneumonia treated with steroids and remdesivir. He had pyelonephritis and urinary culture grown Klebsiella. He was referred as a case of non-resolving vitreous haemorrhage. Visual acuity (VA) was hand movements with fundus showing dense vitritis. He underwent pars plana vitrectomy, vitreous biopsy with intraocular antibiotics (imipenem) suspecting as a case of endogenous bacterial endophthalmitis. Vitreous biopsy did not yield organisms on the smear/culture. The patient’s condition worsened with perception of light and fundus showing dense vitritis with discrete yellowish white deposits on the surface of the retina. A repeat vitreous biopsy done along with intravitreal injection of voriconazole (suspecting fungal aetiology) grown fungal colonies and the organism was identified as Cryptococcus laurentii. At 4-month follow-up, the VA improved to 6/24.

  • COVID-19
  • Cryptococcus
  • Ophthalmology
  • Infections
  • Eye

https://doi.org/10.1136/bcr-2021-246637

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    Footnotes

    • Contributors MJD: planning, conduct and reporting of the work. SP: microbiological assesment and reporting of the organism. CM: review of the literature and compilation of data. PKR: Concept,editing and revision of manuscript and gurantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.