Funduscopic Screening of Fungemic Patients: where we Stand
نویسندگان
چکیده
Candida and other fungal species account for approximately 9.5% of nosocomial bloodstream infections in the United States, with an incidence of 4.6 per 10,000 admissions [1]. Patients with a history of diabetes, indwelling lines/catheters, hyperalimentation, and immunocompromise are at increased risk for fungal bloodstream infections [2-5]. Dissemination of fungal organisms to the eye can occur via hematogenous seeding of small retinal and choroidal capillaries. Localized ocular fungal proliferation can progress to focal or multifocal inflammatory lesions manifesting as chorioretinitis and subsequent abscess formation and vitreous seeding can then lead to frank endophthalmitis. Fungal chorioretinitis and endophthalmitis carry the potential to cause devastating vision loss. Early recognition and prompt treatment can confer more favorable outcomes [6]. Previous studies in a variety of clinical settings not necessarily applicable to the modern tertiary care hospital demonstrated that patients with fungemia developed ocular involvement in 10% to 45% of cases [7-10]. These historically high rates have justified routine funduscopic screening of inpatients for ocular fungal involvement.
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