PURPOSE: To report a rare case of endogenous endophthalmitis in pregnancy and the challenges of managing culture-negative fungal infection. METHODS: Retrospective case report. A 30-year-old woman presented with a subfoveal chorioretinal lesion with vitritis and anterior chamber inflammation in the context of intravenous drug use. Spectral domain optical coherence tomography and fluorescein angiography were used for documentation and monitoring. RESULTS: After 2 months of systemic and intravitreal injections of amphotericin, the patient had clinical improvement in visual acuity, degree of inflammation, and in the size and activity of the chorioretinal lesion, which was presumed to be fungal in origin. CONCLUSION: Among limited cases of endophthalmitis in pregnancy, we report a challenging case of presumed fungal endogenous endophthalmitis. The patient responded favorably to intravitreal and systemic antifungal medications.
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