CANDIDA PANOPHTHALMITIS WITH IATROGENIC HYPERADRENOCORTICISM IN TWO DOGS

Abstract

Two adult poodles were referred for severe corneal ulcers in both eyes (oculi uterque [OU]) for 1.5 months, and swollen eyelids for approximately 1 week. Ophthalmic examination revealed diffuse corneal edema with grayish deposit and ulcer, uveitis, glaucoma, grayish deposit and necrosis on the third eyelid and conjunctiva, eyelids necrosis, eyelid-eyeball adhesions, and blindness. Cytological examination of the conjunctiva and cornea revealed neutrophilic inflammation, and a bacterial culture revealed Staphylococcus aureus. An adrenocorticotropic hormone stimulation test was performed, strongly indicating iatrogenic hyperadrenocorticism. No improvement was observed after 2 weeks of antibiotic treatment. Fungal cultures from the cornea and conjunctiva were positive for Candida spp. Specific antifungal treatment included topical 5% natamycin eye drops (OU six times daily) and oral itraconazole (5[Formula: see text]mg/kg q12[Formula: see text]h). The grayish deposits of the conjunctiva and cornea were sloughed off, thus facilitating the healing of corneal and eyelids ulcers, over the next 3–4 weeks. Phthisis bulbi and eyelid-eyeball adhesions developed in both dogs after 6 months of follow-up. Based on the fungal isolation by culture, clinical signs, and response to antifungal treatment, Candida spp. panophthalmitis was diagnosed. Fungi should be considered a potential organism in panophthalmitis, especially with a medical history of steroids and antibiotic use. This case report demonstrates the grayish deposits of the cornea, conjunctiva, and third eyelid as possible characteristics of Candida infection in the dogs. To our knowledge, this is the first report of Candida panophthalmitis with iatrogenic hyperadrenocorticism in dogs.