Fungal endophthalmitis is one of the most destructive eye infections and is relatively rare in clinical practice.If not diagnosed and treated promptly, it can severely damage vision and even lead to enucleation.Due to its insidious onset, long course, low positive rates in smears and cultures, and early clinical symptoms similar to uveitis, it is prone to misdiagnosis and missed diagnosis, leading to delayed treatment. A review of the literature indicates that the most common sources of EFE infection are the liver, lung, urinary tract, meningitis, gastrointestinal tract, endocarditis and osteomyelitis.In this paper, we report a case of lumbar spine infection causing bilateral candidal endophthalmitis in a 66-year-old male patient.He initially presented to the ophthalmology department of our hospital with a one-week history of decreased vision in the right eye, specialized examination revealed inflammatory opacity in the vitreous of the right eye, initially diagnosed as uveitis and treated with anti-inflammatory therapy without improvement.As the vision in the right eye continued to decline, aqueous humor aspiration from the anterior chamber of the right eye indicated infection with tropical Candida.Subsequently, the vision in the left eye also gradually decreased.Considering the recent hospitalization in the orthopedic department for lumbar disc degeneration, metagenomics analysis of fibrous cartilage tissue DNA during surgery detected tropical Candida, suggesting bilateral endogenous fungal endophthalmitis,The patient was treated with systemic and local antifungal medications in combination with bilateral vitrectomy surgery.After treatment, the vision recovered well, and there was no recurrence during a one-year follow-up.The objective of this thesis is to deepen the understanding of clinicians on this type of disease by reporting this case and reviewing relevant literature, providing some insights for future clinical diagnosis and treatment, and serving as a warning.
