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Intraocular candidiasis in patients with candidemia. Clinical implications derived from a prospective multicenter
S P Donahue1, C M Greven, J J Zuravleff
1Department of Ophthalmology, University of Pittsburgh, PA.
Ophthalmology
|July 1, 1994
Summary
Candida chorioretinitis affects 9% of patients with candidemia, but no endophthalmitis was observed. Early antifungal treatment appears to prevent progression, and patients with specific risk factors require ophthalmologic screening.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Mycology
Background:
- Candida species are increasingly recognized as nosocomial pathogens.
- Intraocular Candida infections can lead to severe vision loss.
- Understanding ocular involvement in candidemia is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of ocular lesions in patients with candidemia.
- To identify risk factors associated with ocular involvement in candidemia.
- To evaluate the progression of ocular Candida infections.
Main Methods:
- Prospective, multicentered, observational study.
- 118 patients with candidemia underwent ophthalmologic examination within 72 hours of positive blood culture.
- Ocular findings were classified using pre-determined criteria for Candida chorioretinitis and endophthalmitis.
Main Results:
- No cases of Candida endophthalmitis were observed.
- Candida chorioretinitis was present in 9% of patients, all receiving antifungal therapy.
- Risk factors for chorioretinitis included Candida albicans fungemia, multiple positive blood cultures, visual symptoms, and immunosuppression.
Conclusions:
- Systemic antifungal therapy may adequately treat ocular Candida infections, preventing progression to endophthalmitis.
- Patients with candidemia and identified risk factors warrant a formal ophthalmologic examination.
- Routine ophthalmologic screening is recommended for high-risk candidemia patients.