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Ankoor Shah, Devon Ghodasra, Brian VanderBeek; Yield of Ophthalmology Consults in Fungemic Patients in a Tertiary Care Hospital Setting. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2915.
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Fungemia is a common affliction in patients who have undergone a transplant, are immunocompromised, or are critically ill. As it is standard practice is to consult ophthalmology when a patient becomes fungemic, we aim to evaluate the yield of these consults.
A retrospective case series of all inpatient ophthalmology consultations between September 1st, 2010 and August 31st, 2011 at the Hospital of the University of Pennsylvania, a tertiary care center.
A total of 619 new consults were performed during the study period. Among these 619 consults, 69 (11%) were to evaluate for fungal eye involvement and were triggered by positive blood, infected line, or wound cultures. 21 (30%) of these patients were seen in an intensive care unit (ICU) setting and 19 (27%) had lesions consistent with chorioretinal involvement. Only 1 (1.5%) patient had vitreous involvement requiring intravitreal injection of anti-fungal medication.
Consults to rule out ocular involvement in fungemic patients are a significant portion of the total consults performed by the ophthalmology service in our tertiary care setting. The number of patients in which management was changed (addition of intravitreal to systemic antifungal therapy) due to the ophthalmic consult was low. Since these consults represent a substantial portion of total inpatient consults performed by the ophthalmology service in our tertiary care setting, further research is needed to examine the utility of ocular screening for all fungemic patients.
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