Coccidioidal Endophthalmitis Secondary to Coccidoides Posadasii: A Rare Infection in Humans.

Purpose: To describe the first case of Coccidioides posadasii endophthalmitis.

Methods: A 41-year-old man referred for acute retinal necrosis (ARN) failing 3 months of outpatient treatment was referred for further management. Three consecutive pars plana vitrectomies were required to identify C. posadasii as the source of the endophthalmitis. Two amphotericin intravitreal injections were delivered in addition to three foscarnet injections, two clindamycin, and one ceftazidime. Therapeutic intervention was complicated by patient compliance.

Results: Despite repeated surgical and medical intervention, vision was lost. The patient later developed fungal meningitis.

Conclusions: Given parallels between C. posadasii and C. immitis endogenous endophthalmitis, a combined medical and surgical approach can combat C. posadasii in cases of good patient compliance with therapy.