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Nancy Huynh, Han-Ying Peggy Chang, Sheila Borboli-Gerogiannis; Ocular Involvement In Hospitalized Patients With Candidemia: Analysis At A Boston Tertiary Care Center. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2979.
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Candida is a common nosocomial infection, and ophthalmologists are often consulted to rule out ocular involvement in patients with disseminated fungal infection. The purpose of this study is to evaluate the prevalence of ocular involvement, risk factors, and ocular findings in hospitalized patients with systemic Candida species infection at a tertiary care center in Boston.
The records of all inpatient consultations performed at the Brigham and Women’s Hospital from October 2009 to October 2010 were reviewed retrospectively. Records of those consultations requesting evaluation for ocular involvement in patients with Candidemia were identified. All patients underwent an eye exam, including a dilated fundus exam. If the patient was still in the hospital, a second eye exam was performed two weeks after the initial evaluation. Data was collected regarding demographic characteristics, fungal cultures, comorbid diseases, and ocular findings.
Of the 346 inpatient ophthalmology consultations performed at the Brigham and Women’s Hospital over a 12-month period, 36 consults were requested to rule out ocular involvement in patients with Candidemia. The mean patient age was 56 years(range 18-84 years). There were 14 males and 22 females. All patients had positive blood cultures. The species of Candida identified were Candida albicans (55%), Candida parapsilosis (20%), Candida glabrata (11%), Candida tropicalis (8%), and Candida krusei (3%), and Candida lusitaniae (3%). All patients were on antifungal treatment at the time of their initial ophthalmologic evaluation. Three patients had retinal findings. Of the 14 patients who completed a repeat eye exam two weeks after their initial evaluation, no new ocular findings were noted. Risk factors identified were presence of an intravenous catheter (44%), malignancy (39%), abdominal surgery (25%), diabetes (17%), total parenteral nutrition (11%), hemodialysis (8%), and systemic steroid use (8%).
Ocular involvement appears to occur infrequently among patients with systemic Candida infection. Further identification of risk factors for developing ocular disease in patients with Candidemia is needed.
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