Case Report

Endophthalmitis Associated With Intravenous Drug Use

Authors: Kian Keyashian, MD, Preeti N. Malani, MD

Abstract

Infectious complications related to IV drug use represent an important source of morbidity and mortality among this population. We report an informative case of endogenous endophthalmitis related to injection of cocaine mixed with lemon juice. Clinicians should remember that any visual change among patients using injection drugs warrants aggressive workup, including empiric antifungal therapy. Once the disease is identified, early vitrectomy should be considered.


Key Points


* The practice of dissolving heroin in lemon juice before injection among drug users can result in Candida endophthalmitis.


* Any visual change among patients using injection drugs warrants aggressive work-up, including empiric antifungal therapy.


* Once the Candida endophthalmitis is identified, early vitrectomy should be considered.

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References

1. Leen CL, Brettle RP. Fungal infection in drug users. J Antimicrob Chemother 1991;28S:83–96.
 
2. Bisbe J, Miro JM, Latoree X, et al. Disseminated candidiasis in addicts who use brown heroin: a report of 83 cases and review. Clin Infect Dis 1992;15:910–923.
 
3. Shankland GS, Richardson MD. Possible role of preserved lemon juice in the epidemiology of Candida endopthalmitis in heroin addicts. Eur J Clin Microbiol Infect Dis 1989;8:87–89.
 
4. Newton-John HF, Wise K, Looke DF. Role of lemon in disseminated candidiasis of heroin abusers. Med J Aust 1984;140:780–781.
 
5. Martinez-Vazques C, Fernandez-Ulloa J, Bordon J. Candida albicans endopthalmitis in brown heroin addicts: response to early vitrectomy preceded and followed by antifungal therapy. Clin Infect Dis 1998;27:1130–1133.