Candidemia, or fungal bloodstream infection, can lead to endophthalmitis, a serious eye infection, through hematogenous dissemination (seeding of the eye with fungi from the bloodstream), with Candida chorioretinitis (inflammation of the retina and choroid) and vitritis (inflammation of the vitreous humor) being common manifestations. 

Here’s a more detailed explanation:

• Candida Endophthalmitis:This is a fungal infection within the eye, often caused by Candida species, a type of yeast.Â
• Candidemia:This refers to a bloodstream infection caused by Candida species.Â
• Pathogenesis:
  • Candidemia can lead to hematogenous dissemination, meaning the fungi can travel through the bloodstream and reach the eyes.Â
  • Fungi often first seed the highly vascular choroid (the layer of tissue between the retina and the sclera), and then the infection can progress through the retina into the vitreous.Â
• Ocular Manifestations:
  • Candida Chorioretinitis: Inflammation and damage to the retina and choroid.Â
  • Vitritis: Inflammation of the vitreous humor (the gel-like substance that fills the space inside the eye).Â
  • Fluffy balls: These are characteristic of Candida endophthalmitis and represent fungal masses within the vitreous.Â
• Risk Factors:
  • Prolonged indwelling intravenous catheters.Â
  • Immunocompromised individuals.Â
  • Systemic antibiotic use.Â
  • Chronic diseases.Â
  • Hospitalized neonates.Â
• Diagnosis:
  • Ophthalmological examination is crucial for detecting retinal lesions and vitritis.Â
  • Blood cultures can confirm candidemia.Â
  • Vitreous samples can be taken for fungal culture and identification.Â