Should all patients with candidaemia have an ophthalmic examination to rule out ocular candidiasis?

Krishna, Rohit; Amuh, D.; Lowder, Careen Y.; Gordon, Steven M.; Adal, Karim A.; Hall, Geraldine S.

doi:10.1038/eye.2000.7

Cited by 82 publications

(63 citation statements)

References 12 publications

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“…The most common predisposing factors identified by Edwards et al [13] include the use of multiple antibiotics (84%), surgery (63%), immunosuppression (54%), indwelling intravenous catheters that provide portals of entry for microorganisms (46%), malignancy (21%), diabetes (13%), liver disease (8%), and alcoholism (8%). These findings correlate with those of other studies [5,6,[8][9][10][15][16][17][18][23][24][25][26] (Table 1). Similar risk factors have been described for hematogenous bacterial endophthalmitis [3,[27][28][29].…”

Section: Endogenous Fungal Endophthalmitissupporting

confidence: 92%

“…Prevalence. The incidence of ocular candidiasis in patients with candidemia may range from 0 up to 50% [5,6,[8][9][10][11][14][15][16][17][18][19][20][21][22][23]. This variation may be related to differences in the criteria and methods of ophthalmologic examination, the retrospective nature of some reports, and relatively small samples of patients studied.…”

Section: Endogenous Fungal Endophthalmitismentioning

confidence: 99%

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Uncommon ophthalmologic disorders in intensive care unit patients

Grixti

Sadri

Datta

2012

Journal of Critical Care

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Section: Endogenous Fungal Endophthalmitissupporting

confidence: 92%

Section: Endogenous Fungal Endophthalmitismentioning

confidence: 99%

Uncommon ophthalmologic disorders in intensive care unit patients

Grixti

Sadri

Datta

2012

Journal of Critical Care

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“…A recent study found ocular Candida chorioretinitis in 26% of the 31 patients with invasive candidiasis. 50 The reported incidence in neonates is 6%. 51 The lesions appear as multiple yellow white elevated spots in the posterior fundus mainly around the macula.…”

Section: Ocular Candidiasismentioning

confidence: 98%

Invasive candidiasis in pediatric intensive care units

Singhi

Deep

2009

Indian J Pediatr

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Candidemia and disseminated candidiasis are major causes of morbidity and mortality in hospitalized patients especially in the intensive care units (ICU). The incidence of invasive candidasis is on a steady rise because of increasing use of multiple antibiotics and invasive procedures carried out in the ICUs. Worldwide there is a shifting trend from C. albicans towards non albicans species, with an associated increase in mortality and antifungal resistance. In the ICU a predisposed host in one who is on broad spectrum antibiotics, parenteral nutrition, and central venous catheters. There are no pathognomonic signs or symptoms. The clinical clues are: unexplained fever or signs of severe sepsis or septic shock while on antibiotics, multiple, non-tender, nodular erythematous cutaneous lesions. The spectrum of infection with candida species range from superficial candidiasis of the skin and mucosa to more serious life threatening infections. Treatment of candidiasis involves removal of the most likely source of infection and drug therapy to speed up the clearance of infection. Amphotericin B remains the initial drug of first choice in hemodynamically unstable critically ill children in the wake of increasing resistance to azoles. Evaluation of newer antifungal agents and precise role of prophylactic therapy in ICU patients is needed.

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“…1 The leading cause of bacterial endogenous endophthalmitis is grampositive species in western countries (gram-negative species in Asian countries), and the leading cause of fungal endogenous endophthalmitis is Candida (followed by aspergillosis). [2][3][4][5][6] Endogenous endophthalmitis associated with hematogenous infections has been recognized for over a century, 7 more commonly among patients with fungemia than bacteremia, 8,9 but with wide variation in reported incidence rates-ranging from 12% to 26% incidence of retinal lesions in bacteremic patients [10][11][12] and from 0 to 78% incidence of chorioretinitis or endophthalmitis in patients with candidemia [13][14][15][16][17][18] -in studies with tens to hundreds of patients with hematogenous infections. 6 Clinical signs include infiltrative chorioretinitis and overlying vitritis (classic for candida endophthalmitis, though uncommon), as well as nonspecific findings such as cotton-wool spots, retinal hemorrhages, and whitecentered Roth spot hemorrhages.…”

mentioning

confidence: 99%