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Author Spotlight: Oral Candida Diagnosis to Advance Clinical Treatment Regimen for pSS Patients
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Do Patients With Candidemia Need an Ophthalmologic Examination?

Alice Lehman1, Katelyn M Tessier2, Victoria Sattarova3

  • 1Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA.

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Summary

Ophthalmology screenings for candidemia detected presumed ocular candidiasis in 6% of patients, with higher sensitivity after seven days. Continued screening is suggested despite inconclusive outcome data.

Keywords:
Candida endophthalmitiscandidemiachorioretinitisocular candidiasisophthalmology screening

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Medical Research

Background:

  • Conflicting recommendations exist regarding screening dilated retinal examinations for patients with candidemia.
  • The Infectious Diseases Society of America recommends screening, while the American Academy of Ophthalmology advises against routine screening in asymptomatic patients.

Purpose of the Study:

  • To investigate the incidence of ocular complications in patients with candidemia.
  • To evaluate the rate of fundoscopic examinations, identify risk factors for ocular complications, and analyze management changes and outcomes.

Main Methods:

  • A collaborative study involving infectious diseases and ophthalmology departments.
  • Examination of 308 patients diagnosed with candidemia.
  • Assessment of fundoscopic examination rates, risk factors, management, and outcomes.

Main Results:

  • Presumed Candida chorioretinitis was diagnosed in 6% (9/148) of patients who underwent fundoscopic exams.
  • Of those diagnosed, 44% were asymptomatic, and 22% could not report symptoms.
  • Ocular candidiasis detection was more sensitive in exams conducted more than seven days after the first positive Candida blood culture.

Conclusions:

  • Continued ophthalmological screening for candidemia is considered prudent due to the risk of ocular morbidity.
  • A definitive consensus on screening protocols remains challenging due to a lack of outcome data.
  • Further research is warranted, and screenings appear more sensitive when performed over seven days post-blood culture.