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Neonatal candidiasis: ophthalmologic infection.
Jill E Baley1, Forrest J Ellis
1Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106-6010, USA. jxb13@po.cwru.edu
Seminars in Perinatology
|November 25, 2003
Summary
Ocular candidiasis in preterm infants can lead to endophthalmitis, a serious eye infection. Early antifungal treatment is crucial for preventing vision loss in infants with candidemia.
Area of Science:
- Ophthalmology
- Neonatology
- Infectious Diseases
Background:
- Endophthalmitis in preterm infants is a severe complication of systemic candidiasis.
- While early systemic antifungal therapy reduces ocular involvement, it still occurs in approximately 6% of cases.
- Prolonged candidemia increases the risk of eye disease, which can manifest early or later in infancy.
Purpose of the Study:
- To review the presentation, diagnosis, and management of endophthalmitis in preterm infants with candidiasis.
- To highlight the role of Candida species in neonatal eye infections.
- To discuss the impact of candidemia on retinopathy of prematurity.
Main Methods:
- Review of clinical presentations and diagnostic findings.
- Ophthalmoscopic examination for characteristic retinal and vitreal lesions.
- Assessment of treatment outcomes with systemic antifungal therapy and surgical interventions.
Main Results:
- Characteristic findings include unilateral or bilateral yellow-white retinal/vitreal lesions with hemorrhage and vitreous haze.
- Systemic antifungal therapy is often effective, but some cases require lensectomy for persistent or recurrent infections, especially lens abscesses.
- Candidemia is associated with the progression of retinopathy of prematurity.
Conclusions:
- Prompt diagnosis and systemic antifungal treatment are vital for preserving vision in preterm infants with ocular candidiasis.
- Ocular complications, such as lens abscesses, may necessitate surgical intervention.
- The link between candidemia and retinopathy of prematurity progression warrants further investigation.