Uvea: endogenous Candida endophthalmitis: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Uvea: endogenous Candida endophthalmitis

Sample item

A 34-year-old man in the intensive care unit with a central venous catheter and parenteral nutrition develops blurred vision. Fundus examination shows creamy white fluffy chorioretinal lesions with vitreous colonies arranged like a string of pearls. Which is the commonest causative organism?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Candida albicans

Candida is the commonest cause of endogenous fungal endophthalmitis in hospitalised patients with indwelling lines, parenteral nutrition or intravenous drug use. Systemic antifungals are given, and vitrectomy with intravitreal antifungal is added when the vitreous is involved.

Option by option

  • A. Toxoplasma gondii

    Toxoplasma causes a focal necrotising retinochoroiditis with a headlight-in-fog appearance.

  • B. Candida albicans (correct)

    Correct. Candida albicans causes fluffy lesions and a string-of-pearls vitreous in this risk group.

  • C. Staphylococcus aureus

    Staphylococcus aureus causes an acute bacterial endogenous endophthalmitis with a rapid, purulent course.

  • D. Aspergillus fumigatus

    Aspergillus is a much less common cause of endogenous fungal endophthalmitis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is B, Candida albicans. Candida is the commonest cause of endogenous fungal endophthalmitis in hospitalised patients with indwelling lines, parenteral nutrition or intravenous drug use.

Why is "Toxoplasma gondii" not the answer?

Toxoplasma causes a focal necrotising retinochoroiditis with a headlight-in-fog appearance.

Why is "Staphylococcus aureus" not the answer?

Staphylococcus aureus causes an acute bacterial endogenous endophthalmitis with a rapid, purulent course.

Why is "Aspergillus fumigatus" not the answer?

Aspergillus is a much less common cause of endogenous fungal endophthalmitis.

What concept does this question test?

It tests Uvea: endogenous Candida endophthalmitis in Ophthalmology. Systemic antifungals are given, and vitrectomy with intravitreal antifungal is added when the vitreous is involved.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Uvea: endogenous Candida endophthalmitis?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.