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M. Tonini; Specific PCR for Candida and Aspergillus Fumigatus for the Etiological Diagnosis of Endophtalmitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):690.
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Evaluation of specific PCR for Candida and Aspergillus in patients suffering exogenous and endogenous endophthalmitis.
These PCR techniques were assessed in 109 eyes of 109 patients studied in a multicentric prospective study (FRIENDS group 2004-2005) 92 acute post-operative endophthalmitis, 2 cases of delayed post-operative endophtalmitis, 2 cases of chronic post-operative endophthalmitis, 9 cases of post-trauma endophthalmitis, 3 cases of endogenous endophthalmitis and one case with acute endophthalmitis after intravitreal injection were included.Aqueous humor (AH) and/or vitreous samples were performed in emergency for each patient. PCR for Candida and Aspergillus were systematically performed on AH and vitreous samples whereas, due to the limited amount of AH, fungal culture (Sabouraud) was preferentially done on vitreous samples.
PCR for Candida : On 80 AH samples, one case was positive for Candida using both PCR and culture. No Candida was identified in any vitreous sample from vitreous tap using both techniques(n=30). One case of Candida endophthalmitis has been diagnosed using culture of vitreous from a biopsy during vitrectomy (n=61), but PCR was negative. A patient with a septicemia due to Candida albicans and Candida guilliermondii had a negative PCR and culture from AH samples. PCR for Aspergillus:A false positive case of PCR for Aspergillus was identified on the vitreous from vitrectomy in a patient infected by S. epidermidis (the clinical evolution was good after intravitreal injection of antibiotics).
No acute fungal post-operative endophthalmitis was identified using culture and PCR in this large series of patients from Western Europe. The specificity and sensitivity of PCR for Candida need to be studied in a larger series of endogenous endophthalmitis.
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