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Cryptococcal endophthalmitis in a patient with malignancy: A case report and literature review

Summary

A 50-year-old woman with advanced lung cancer developed a rare fungal eye infection caused by Cryptococcus neoformans, resulting in blurred vision. Doctors diagnosed this through eye surgery and fluid analysis, then treated her with strong antifungal medications both injected into the eye and given systemically. After 10 months of treatment, her vision significantly improved, showing that early detection and aggressive antifungal therapy are critical for preventing blindness from this rare infection.

Background

Cryptococcal endophthalmitis is a rare manifestation of Cryptococcus neoformans infection typically occurring in severely immunocompromised patients. While well-documented in HIV and transplant populations, its occurrence in malignancy patients undergoing chemotherapy is rarely reported.

Objective

This case report presents a 50-year-old female with advanced-stage lung cancer presenting with cryptococcal endophthalmitis and reviews the literature on this rare ocular complication in non-HIV, non-transplant patients.

Results

Visual acuity in the affected left eye improved from counting fingers at 2 feet to 3/60 with pinhole correction of 6/18 after 10 months of treatment. The patient responded well to combined systemic and intravitreal antifungal therapy, demonstrating significant visual recovery.

Conclusion

This case highlights the importance of maintaining high clinical suspicion for fungal endophthalmitis in malignancy patients with immunosuppression. Early diagnosis through pars plana vitrectomy and aggressive dual systemic-intravitreal antifungal therapy are crucial for preventing irreversible vision loss in cryptococcal endophthalmitis.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40949006
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