Vitreoretinal Involvement in Patients With Fungemia at a Tertiary Care Hospital.

IF 0.5 Q4 OPHTHALMOLOGY
Carl S Wilkins, Karina Esquenazi, Kyle Hirabayashi, Jeffrey Brown, Rupak Bhuyan, Niathi Kona, Alexander Barash, Robin B Ginsburg, Avnish Deobhakta, Gareth M Lema
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Abstract

Purpose: To identify the prevalence of fungal ophthalmic involvement and evaluate risk factors for positive screening for inpatients at an academic tertiary care hospital by assessing a priori screening criteria that may determine which patients need ophthalmic evaluation. Methods: This retrospective cohort study comprised patients with a documented positive blood culture for fungemia and an ophthalmic screening examination from January 1, 2015, to September 30, 2019. Ophthalmology notes and laboratory results taken during admission were evaluated. The primary outcomes were ocular involvement, presence of visual complaints, and duration of blood culture positivity. Variables assessed included recent gastrointestinal surgery, organ transplantation, HIV infection, diabetes mellitus, intravenous drug use, and central venous access. Analyses, including the Student t test, χ2 test, and logistic regression, were performed. Results: Of 291 patients with fungemia, 7 had ocular involvement (3 with chorioretinitis; 4 with endophthalmitis). One patient with endophthalmitis required an intravitreal antifungal injection. No patient with chorioretinitis required injections or surgery. The mean culture positivity length was 5 days for those with vitreoretinal involvement and 4 days for those without vitreoretinal involvement (P > .05). Of patients with ocular involvement, 40.0% had a visual complaint compared with 4.2% without ocular involvement (P < .05). The negative predictive value was 99.3% for patients without complaints or persistent fungemia. Conclusions: Patients with visual complaints at the time of a positive blood culture for fungemia are at risk for ocular disease and require screening.

三级医院真菌血症患者的玻璃体视网膜受累
目的:通过评估可能决定哪些患者需要眼科评估的先验筛查标准,确定学术三级医院住院患者真菌性眼部侵犯的患病率,并评估阳性筛查的危险因素。方法:本回顾性队列研究纳入2015年1月1日至2019年9月30日期间真菌血症血培养阳性并进行眼科筛查检查的患者。评估入院时的眼科记录和实验室结果。主要结果是眼部受累、视力不适和血培养阳性持续时间。评估的变量包括近期胃肠手术、器官移植、HIV感染、糖尿病、静脉用药和中心静脉通路。采用Student t检验、χ2检验和logistic回归进行分析。结果:291例真菌血症患者中,7例有眼部受累(3例有脉络膜视网膜炎;4伴有眼内炎)。一名眼内炎患者需要玻璃体内抗真菌注射。没有绒毛膜视网膜炎患者需要注射或手术。玻璃体视网膜受累组平均培养时间为5天,无玻璃体视网膜受累组平均培养时间为4天(P < 0.05)。在眼部受累的患者中,40.0%有视力不适,而无眼部受累的患者为4.2% (P结论:真菌血症血培养阳性时出现视力不适的患者有眼部疾病的风险,需要进行筛查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.20
自引率
16.70%
发文量
0
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