Source of infection in candida endophthalmitis in drug addicts

Heroin addiction is currently a major medical and social problem in Great Britain. An epidemic of presumed candidal endophthalmitis, a recognised complication of heroin abuse, was recently reported from Glasgow. We report the results of our attempts to ascertain the possible origins of the infection in addicts. Twenty three heroin addicts were diagnosed as having candidal endophthalmitis between November 1982 and August 1985. The diagnostic criteria have been described. This study suggests that the juice in plastic lemons from which preservative, sulphur dioxide, has evaporated can become contaminated with C albicans, probably from the addict's flora. Although legal restrictions precluded us from analysing herin sold in the street for fungal contamination, the fact that diacetylmorphine was found to be fungicidal for C albicans suggests that the heroin itself was a less likely source of infection.