Endogenou mycotic endophthalmiti: variation in clinical and hitopathologic change in candidiai compared with apergilloi

PURPOE: To decribe clinical and/or hitopathologic feature that could help ditinguih endogenou Candida endophthalmiti from endogenou Apergillu intraocular inflammation and to provide hitologic documentation of intraocular pread of thee agent. METHOD: Twenty-five patient who underwent enucleation, 13 with morphologic feature and/or poitive culture for Apergillu and 12 with hitologic evidence and/or poitive culture for Candida were included in the tudy. Clinical information wa ought from each cae. Patient with AID were excluded. The enucleated globe were analyzed to detect location of the fungi, vacular invaion by thee agent, and inflammatory repone. REULT: Candida endophthalmiti wa noted in patient with a hitory of gatrointetinal urgery, hyperalimentation, or diabete mellitu, wherea apergilloi wa preent in patient who had undergone organ tranplantation or cardiac urgery. Hitopathologically, the vitreou wa the primary focu of infection for Candida, wherea ubretinal/ubretinal pigment epithelium infection wa noted in eye with apergilloi. Retinal and choroidal veel wall invaion by fungal element wa noted in cae of apergilloi but not in cae with candidiai. Both infectiou agent induced uppurative nongranulomatou inflammation. CONCLUION: Unlike Candida endophthalmiti, apergilloi clinically preent with extenive area of deep retiniti/choroiditi, and vitreou biopy may not yield poitive reult. Hitopathologically, it appear that Apergillu grow preferentially along ubretinal pigment epithelium and ubretinal pace. Thi intraocular infection i uually aociated with a high rate of mortality caued by cerebral and cardiac complication