ABSTRACT
Four months after undergoing extracapsular cataract extraction with implantation of a posterior chamber intraocular lens, a 74-year-old woman developed granulomatous anterior uveitis. Although she initially responded well to corticosteroid therapy, she experienced multiple recurrences on discontinuation of this therapy. Slit-lamp examination showed the ocular inflammation to be associated with white cortical material within the lens capsular sac. She underwent removal of the implant as well as the lens capsular sac. Anaerobic culture yielded no organisms, but fungus cultures yielded Torulopsis candida. Histopathologic and electron microscopic studies showed large numbers of yeast sequestered within the lens capsular sac and mild granulomatous inflammation around the sac. Torulopsis candida is occasionally isolated from specimens as a contaminant, but has not yet been shown to produce human disease. The case reported herein documents potential pathogenicity of Torulopsis candida and reveals the importance of organisms other than anaerobic bacteria in causing delayed and localized intraocular inflammation that is virtually identical to Propionibacterium acnes infection.
Subject(s)
Candidiasis/diagnosis , Endophthalmitis/microbiology , Eye Infections, Bacterial/diagnosis , Eye Infections, Fungal/diagnosis , Gram-Positive Bacterial Infections/diagnosis , Propionibacterium acnes , Aged , Candidiasis/pathology , Cataract Extraction , Diagnosis, Differential , Endophthalmitis/pathology , Eye Infections, Fungal/pathology , Female , Humans , Lenses, Intraocular , Postoperative Complications/microbiologyABSTRACT
Diabetic ketoacidosis may occur in women treated with intravenous beta-sympathomimetic agents for tocolysis. We describe diabetic ketoacidosis and transient severe insulin resistance in a woman with diabetes who was treated with subcutaneous terbutaline infusion. Subcutaneous terbutaline infusion may precipitate transient insulin resistance and diabetic ketoacidosis in women with diabetes.
