전립선암 환자에서 로봇을 이용한 복강경 근치적 전립선적출술 후 발생한 양안 칸디다 안내염

Bilateral Candida albicans Endophthalmitis after Robot-Assisted Laparoscopic Radical Prostatectomy in a Patient with Prostate Adenocarcinoma

Purpose: To report a case of bilateral Candida albicans endophthalmitis after robot-assisted laparoscopic radical prostatectomy (RALP) in a patient with prostate adenocarcinoma. Case summary: A 61-year-old male patient had RALP for prostate adenocarcinoma. Four days after the surgery, the patient had a fever and pancytopenia. Two weeks after the surgery, the patient complained of decreased visual acuity in both eyes. Best-corrected visual acuity (BCVA) was counting fingers at 60 cm in the right eye and 20/63 in the left eye. The fundus examination showed vitreous opacity and yellow circumscribed chorioretinal lesions in both eyes. The blood and urine cultures were negative. An intravitreal voriconazole injection (100 μg/0.1 ml) was given in both eyes. However, the vitritis worsened, and BCVA decreased to counting fingers at 30 cm in the right eye and 60 cm in the left eye. Thus, combined phacoemulsification and 23-gauge microincisional vitrectomy surgery with a silicone oil injection was performed in both eyes at 1-week intervals. The vitrectomy sample culture was positive for Candida albicans in both eyes. Four months after the vitrectomy, BCVA was 20/100 in both eyes without subretinal lesions. Conclusions: Clinicians should be aware that bilateral Candida albicans endophthalmitis could be complicated by RALP in a patient with prostate adenocarcinoma or with other risk factors.