Ophthalmia " Adultorum" Secondary to Cytomegalovirus and Candida albicans Isolates from Right Eye Ulcer of an Alcoholic: The Benin City Experience

Abstract

Background: Eye injuries are more common and have more severe effects when they occur in developing countries. The factors reponsible for these eye injuries can be linked to socioeconomic status, insufficient safety precautions, a lack of ideal treatment facilities, the use of conventional eye medication, and low levels of education. Ocular trauma has been identified in studies from Nigeria and other African countries as a major contributing factor to monocular blindness. In neonates, conjunctivitis within the first 28 days of life is termed “Ophthalmia neonatorium”. Conjunctivitis arising from either viral, bacteria or fungal causes in an Adult is what we termed as “Ophthalmia Adultorum".  In our study the individual was a chronic alcoholic who was already immunosuppressed from his large alcohol intake. This study therefore is case report of a traumatic innoculation causing Ophthalmia Adultorum in a male alcoholic, a university of Benin Teaching Hospital experience. Methods: This is a case report. Results: A 57 year old man who  was admitted on 25 September, 2023, as a case of  Cytomegalovirus  (CMV ) and Candida albicans associated  Conjunctivitis ,after a  traumatic  sandball inoculation to his right eye . Conjunctiva swab for microscopy and culture was sent to the medical microbiology laboratory. Gram stain showed yeasts cells, while 10%giemsa staining of the eye swab showed ztanck cells. Culture yielded Candida albicans. He was placed on chloramphenicol eye drop, steroid eye drops, Acyclovir (patient could not afford gangcyclovir the specific antiviral drug due to high cost) and fluconazole eye drops. Patient was managed by the ophthalmologists and the Medical Microbiology team. Patient was discharged home on the 5th day  and was asked to come for follow up after one week .On follow up visit , previous symptoms had resolved and right and left eyes were both normal on examination. Conclusion: We are unaware of any previous reports of Ophthalmia Adultorium involving Cytomegalovirus and Candida albicans in patients with sandball eye accidents. Patients with sandball injuries should be assessed quickly and antibiotic and antifungal therapy should be considered if cultures are positive.