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Effect of immunosuppression on the development of experimental hematogenous Candida endophthalmitis
Abstract:
The induction of neutropenia and immunosuppression by the administration of nitrogen mustard (HN2) decreased the frequency and altered the morphology of clinically detectable hematogenous Candida endophthalmitis in the rabbit model of disseminated candidiasis. Whereas 95% of eyes in rabbits infected with Candida albicans without pretreatment with HN2 developed typical lesions of hematogenous Candida endophthalmitis, only 6.2% of eyes in rabbits that had been given 3.0 mg of HN2 per kg developed clinically detectable endophthalmitis. Lesions that developed in the severely immunocompromised and neutropenic rabbits were small and atypical in appearance. From these data, we conclude that ophthalmoscopic examination may not be a sensitive diagnostic modality for disseminated candidiasis in severely immunocompromised, neutropenic patients.
Insights
Nitrogen mustard (HN2) significantly reduced detectable Candida endophthalmitis in rabbits. Ophthalmoscopy may be insensitive for diagnosing disseminated candidiasis in neutropenic patients.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Hematogenous Candida endophthalmitis is a serious complication of disseminated candidiasis.
- Ophthalmoscopic examination is a common method for diagnosing endophthalmitis.
- Immunocompromised patients are at increased risk for disseminated candidiasis.
Purpose of the Study:
- To investigate the effect of nitrogen mustard (HN2)-induced neutropenia and immunosuppression on the development and clinical detection of hematogenous Candida endophthalmitis in a rabbit model.
- To assess the sensitivity of ophthalmoscopic examination for diagnosing disseminated candidiasis in severely immunocompromised, neutropenic states.
Main Methods:
- Rabbits were infected with Candida albicans to induce disseminated candidiasis.
- A subset of rabbits received pretreatment with nitrogen mustard (HN2) to induce neutropenia and immunosuppression.
- Eyes were examined clinically for the development of endophthalmitis lesions.
- Morphology of lesions was assessed in affected eyes.
Main Results:
- 95% of untreated rabbits developed clinically detectable Candida endophthalmitis.
- Only 6.2% of HN2-treated rabbits developed clinically detectable endophthalmitis.
- Endophthalmitis lesions in HN2-treated rabbits were small and atypical in appearance.
Conclusions:
- Induction of neutropenia and immunosuppression with HN2 significantly decreased the frequency of clinically detectable hematogenous Candida endophthalmitis in rabbits.
- Ophthalmoscopic examination may not be a sensitive diagnostic tool for disseminated candidiasis in severely immunocompromised, neutropenic patients.