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[Etiology and pathogens of fungal endophthalmitis]

Shiying Sun1, Ge Zhao1, Xiaoyan Sun1

  • 1Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, China.

[Zhonghua Yan Ke Za Zhi] Chinese Journal of Ophthalmology
|January 14, 2015
PubMed
Abstract

Insights

Fungal endophthalmitis in North China is mostly exogenous, often linked to fungal keratitis or trauma. Fusarium and Aspergillus are the primary pathogens, showing sensitivity to voriconazole and amphotericin B.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Mycology

Background:

  • Fungal endophthalmitis is a severe intraocular infection.
  • Understanding its epidemiology and laboratory features is crucial for effective management.

Purpose of the Study:

  • To investigate the epidemiologic characteristics and laboratory findings of fungal endophthalmitis in North China.
  • To identify common causative fungal pathogens and their antifungal susceptibility.

Main Methods:

  • Retrospective analysis of 81 patients diagnosed with fungal endophthalmitis between 2000 and 2012.
  • Evaluation of patient history, direct smear examination, fungal culture, and in vitro antifungal sensitivity testing.

Main Results:

  • Exogenous fungal endophthalmitis accounted for 90.1% of cases, primarily associated with fungal keratitis (Fusarium) and penetrating ocular trauma (Aspergillus).
  • Endogenous infections (9.9%) were linked to drug abuse, with Aspergillus as a common pathogen.
  • Microscopic detection of hyphae was positive in 77.6% of smear samples.
  • Fusarium (60.5%) and Aspergillus (21.0%) were the most frequently isolated fungi.

Conclusions:

  • Fungal endophthalmitis in North China is predominantly exogenous, with fungal keratitis and trauma as leading causes.
  • Fusarium and Aspergillus are the most common pathogens, with Fusarium dominating fungal keratitis cases and Aspergillus prevalent in trauma- and endogenous-related infections.
  • Voriconazole and amphotericin B demonstrated higher in vitro efficacy against Fusarium and Aspergillus compared to other tested antifungals.

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