Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Saturday, 10 / 16 / 2021

Abstract

CASE REPORT

Acute-on-chronic Liver Failure in a Patient with Candida Endophthalmitis: A Case Report

Ying Cao1 , Ying Fan1 , Yanbin Wang1 , Xiyao Liu2 and Wen Xie1,*

1  Center of Liver Diseases, Capital Medical University Affiliated to Beijing Ditan Hospital, Beijing, China
2  Department of Ophthalmology, Capital Medical University Affiliated to Beijing Ditan Hospital, Beijing, China
*Correspondence to: Wen Xie, Center of Liver Diseases, Capital Medical University Affiliated to Beijing Ditan Hospital, No. 8, Jingshun East Street, Chaoyang District, Beijing 100015, China. ORCID:https://orcid.org/0000-0002-7314-8175. Tel: +86-10-84322816, Fax: +86-10-84322818, E-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2021;9(3):447-451 DOI: 10.14218/JCTH.2020.00092
Received: October 11, 2020 Accepted: March 1, 2021 Published online: March 30, 2021

Abstract

Acute-on-chronic liver failure (ACLF) is a risk factor for fungal infection. Endogenous fungal endophthalmitis is a serious, sight-threatening disease. Common causes include immunocompromised state and intravenous drug use, permitting opportunistic pathogens to reach the eye through the blood stream. We report a case of Candida endophthalmitis in a 47 year-old woman who was admitted to our hospital with ACLF and poorly controlled diabetes. In addition, she was treated with glucocorticoids due to severe jaundice. After treatment for ACLF, the patient experienced fever with blurred vision in the left eye and was diagnosed with candidemia, endogenous Candida endophthalmitis in the left eye, and chorioretinitis in the right eye. Systemic and topical antifungal treatment was administered based on the positive Candida albicans test in intraocular fluid using second-generation sequencing. The patient underwent vitrectomy in the left eye and C. albicans was confirmed in vitreous cultures. Follow-up visit, at 6 weeks after the operation, showed only light perception in the left eye and stable visual acuity in the right eye. Physicians should be aware of endogenous fungal endophthalmitis in patients with ACLF, especially those with Candida infection, a history of glucocorticoid use, and diabetes. A dilated retinal examination should be performed by an ophthalmologist if ACLF patients develop fever and fungal infection.

Keywords

Acute-on-chronic liver failure, Candida endophthalmitis, Candida albicans, Glucocorticoid, Case report

Journal of Clinical and Translational Hepatology 2021 vol. 9, 447-451  [ Html  ] [ PDF Full-text ]

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