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Fungal endophthalmitis associated with compounded products

Christina A Mikosz, Rachel M Smith, Moon Kim

    Emerging Infectious Diseases
    |January 23, 2014
    PubMed

    Insights

    Outbreaks of fungal endophthalmitis occurred after eye procedures due to contaminated compounded medications. These infections, linked to Brilliant Blue G dye and triamcinolone acetonide, led to widespread vision loss and product recalls.

    Area of Science:

    • Ophthalmology
    • Infectious Diseases
    • Public Health

    Background:

    • Fungal endophthalmitis is a severe ocular infection.
    • In March 2012, a national outbreak of fungal endophthalmitis was identified following invasive ocular procedures.

    Purpose of the Study:

    • To investigate the cause of concurrent fungal endophthalmitis outbreaks.
    • To identify the source and associated risk factors for these infections.

    Main Methods:

    • Retrospective case-control study involving 47 patients across 9 states.
    • Microbiological analysis of patient specimens and compounded drug products.
    • Epidemiological investigation to determine exposure and risk factors.

    Main Results:

    • Two distinct outbreaks were identified, linked to a single compounding pharmacy.
    • One outbreak involved Brilliant Blue G (BBG) dye (Fusarium incarnatum-equiseti complex), the other triamcinolone acetonide (Bipolaris hawaiiensis).
    • Exposure to either compounded product was the sole identified risk factor; 98% of affected patients experienced vision loss.

    Conclusions:

    • Contaminated compounded medications pose a significant risk for serious ocular infections.
    • Ensuring the safety and integrity of compounded pharmaceuticals is crucial for preventing patient harm.
    • These outbreaks necessitated product recalls and highlighted the need for stringent regulatory oversight.
    Keywords:
    Bipolaris hawaiiensisFranck’sFusarium incarnatum-equiseticompoundingdisease outbreaksendophthalmitiseye infectionsfungalfungimold

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