Cases of endophthalmitis caused by Candida albicans and Candida dubliniensis identified via internal transcribed spacer deep sequencing

BMC Ophthalmol. 2024 Oct 9;24(1):444. doi: 10.1186/s12886-024-03702-4.

Abstract

Background: We report two cases of fungal endophthalmitis induced by Candida species identified based on internal transcribed spacer 1 (ITS1) sequencing.

Case presentation: In two cases, endophthalmitis was suspected, and the patients underwent pars plana vitrectomy. Case 1 was a 64-year-old woman with a history of cataract surgery 10 days prior. She had a history of anal primary melanoma, which metastasized throughout the body and subsequently relapsed. Vitreous culture and ITS-1 deep sequencing revealed the presence of the rare fungus, Candida dubliniensis. Case 2 was a 54-year-old man with a history of liver cancer and kidney failure. Culture methods and ITS1 deep sequencing both revealed the presence of Candida albicans. Both patients exhibited good visual prognoses after treatment with topical and systemic antibiotics.

Conclusions: We present two cases of fungal endophthalmitis caused by two Candida species identified by both the culture method and ITS1 deep sequencing. The fungal pathogen was identified by ITS deep sequencing three days after sample submission; the culture method yielded results after 1 week. These findings support the applicability of ITS1 sequencing for timely pathogen identification for cases of fungal endophthalmitis and provide detailed taxonomic information at the species level.

Keywords: Candida albicans; Candida dubliniensis; Deep sequencing; Endophthalmitis; Internal transcribed spacer; Metagenomic analysis.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Candida albicans* / genetics
  • Candida albicans* / isolation & purification
  • Candida* / genetics
  • Candida* / isolation & purification
  • Candidiasis* / diagnosis
  • Candidiasis* / drug therapy
  • Candidiasis* / microbiology
  • DNA, Fungal / genetics
  • Endophthalmitis* / diagnosis
  • Endophthalmitis* / microbiology
  • Eye Infections, Fungal* / diagnosis
  • Eye Infections, Fungal* / microbiology
  • Female
  • High-Throughput Nucleotide Sequencing*
  • Humans
  • Male
  • Middle Aged
  • Vitrectomy
  • Vitreous Body / microbiology

Substances

  • DNA, Fungal
  • Antifungal Agents