Resolution of Coccidioides immitis endophthalmitis with an aggressive surgical and medical therapeutic approach.

INTRODUCTION

Coccidioides immitis endophthalmitis usually results in enucleation, and there is evidence that vitrectomized eyes are more likely to become enucleated.

METHODS

A 55-year-old man presented to us with steroid-resistant granulomatous uveitis and was eventually diagnosed with C. immitis endophthalmitis. He was treated with an aggressive medical and surgical approach, receiving a total of 16 intravitreal antifungal injections and three vitrectomies, as well as lensectomy and penetrating keratoplasty.

RESULTS

At 13 months after presentation, the patient's eye was free of inflammation, and his best corrected visual acuity was 20/25.

DISCUSSION: This is the first reported case of culture-proven C. immitis endophthalmitis with a favorable final outcome. We propose that the good outcome may have been due to our aggressive therapeutic approach.