Abstract
Abstract: :
Purpose: To estimate the incidence of fungal endophthalmitis among adult and pediatric inpatients with known or suspected fungemia. Methods: Clinical data from the adult and pediatric inpatient ophthalmology consult services of a single academic tertiary medical center (Georgetown University Medical Center) were obtained for retrospective study. Among these were identified 158 ophthalmology consults (94 adult consults, 64 pediatric consults) obtained by physicians between August, 1991 and November, 2001 to exclude fungal endophthalmitis. The study population consisted of 295 eyes of 149 patients (88 adult, 61 pediatric) obtained from these 158 consults. Studied variables included patient age and sex, presence of documented fungemia, institution of antifungal therapy, presence of visual symptoms, and visual acuity. Dilated fundoscopic exam findings were then reviewed for documentation of vitritis, vitreous opacities, or chorioretinitis consistent with fungal endophthalmitis. Results: Two (1.3%) of 149 adult and pediatric patients demonstrated clinical evidence of fungal endophthalmitis. Both cases of fungal endophthalmitis were diagnosed in low birth weight, premature infants. The incidence of fungal endophthalmitis among the subgroup of 56 infants was 3.6%. None (0%) of the 88 adult patients studied were noted to have clinical evidence for fungal endophthalmitis at the time of consultation. Three (3.4%) of the 88 adult patients had documentation and clinical findings consistent with previous fungal endophthalmitis. Among the high-risk group of 59 symptomatic or nonverbal adult and pediatric patients with fungemia confirmed by blood culture, 1 patient (1.7%) had clinical evidence for fungal endophthalmitis. Conclusions: These data suggest a low incidence of fungal endophthalmitis among both adult and pediatric inpatients with suspected or known fungemia. The data also suggest a low prevalence of fungal endophthalmitis among adults in the study group.
Keywords: 354 clinical (human) or epidemiologic studies: prevalence/incidence • 398 endophthalmitis • 414 fungal disease