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IN REPLY. —We would like to submit the following reply to Dr Griffin's letter.We are in complete agreement with Dr Griffin that Candida endophthalmitis is often an important indicator of disseminated systemic candidiasis and that when systemic infection is present, therapy with intravenous amphotericin B or other systemic antifungal medication is indicated. All patients who have lesions have evaluations done, including blood and urine cultures, chest roentgenograms, careful examination for heart murmurs, and other indicated tests, in search of systemic infection. We were careful to point out in our article that our patient did not have such an evaluation because he refused hospitalization on two separate occasions. We certainly did not intend to advocate treating patients with systemic candidiasis with intravitreal amphotericin B alone. However, should intravitreal spread of infection develop in such a patient, we believe that intravitreal amphotericin B should be given in addition to intravenous |
