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Katherine Chen, Juner Colina, Laura Snyder, Seenu M Hariprasad; A Retrospective Case Study of the Incidence of Endogenous Fungal Endophthalmitis in Patients with Positive Blood Cultures for Systemic Fungemia: Review of the Literature. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3859.
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To determine the incidence of fungal ocular involvement, which can manifest as chorioretinitis or endophthalmitis, in patients with positive fungal blood cultures in a tertiary care center.
Retrospective case series and literature review. 100 adult and pediatric inpatients with positive fungal blood cultures.From August 1st, 2006 to October 31st, 2009, inpatient consultations at University of Chicago were evaluated for fungal ocular involvement. Patients were evaluated for the presence or absence of ocular involvement of fungal organisms on clinical exam.
Ophthalmology was consulted on 100 patients with fungemia and only one patient had clinical signs of ocular involvement (1/100, 1%). That patient had blood cultures positive for Candida glabarata, did not have ocular symptoms, and clinically improved after switching antifungal therapy to PO voriconazole. Two patients had nonspecific fundus lesions that were not consistent with chorioretinitis or endophthalmitis. In decreasing order of frequency, Candida albicans, Candida parapsilosis, Candida glabarata, Candida lusitaniae, Candida tropicalis, and others were the organisms identified in the blood cultures.
The incidence of ocular involvement in patients with fungemia is 1% in this study, which is consistent with recent trends in literature. We believe that there needs to be revised guidelines and criteria in screening at-risk inpatients for fungal chorioretinitis and endophthalmitis.
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