Unusual presentation of fungal keratitis and endogenous endophthalmitis in Sézary syndrome: a case report.

Purpose: This report describes an atypical presentation of Candida keratitis and subsequent endogenous bacterial endophthalmitis in a patient with Sézary Syndrome undergoing immunotherapy and subsequently chemotherapy. Observations: A male patient in his late sixties, a rigid gas permeable (RGP) contact lens wearer diagnosed with Sézary Syndrome and undergoing immunotherapy, presented with blurred vision and pain in the right eye. Examination showed a pseudodendritic infiltrate, severe anterior chamber inflammation with hypopyon and B-scan ultrasonography was unremarkable. Herpetic keratouveitis was suspected, and treatment was started with oral acyclovir, topical levofloxacin, and topical dexamethasone, with no improvement after 48 hours. Cultures identified Conclusion: This case highlights the complex relationship between systemic immunosuppression, ocular susceptibility and opportunistic endogenous infections, contributing to a challenging clinical course, diagnosis and treatment of patients with Sézary Syndrome. Clinicians should be aware of this risk of atypical and aggressive infectious presentations and carefully monitor these patients after chemotherapy cycles to detect potential complications early.