Clinical Features and Visual Acuity Outcomes in Culture-Positive Endogenous Fungal Endophthalmitis in Southern China

Purpose To report the causative organisms, management strategies, and visual outcomes of culture-proven endogenous fungal endophthalmitis in a case series from southern China. Methods We reviewed the microbiological and medical records of patients with culture-positive endogenous fungal endophthalmitis visiting the Zhongshan Ophthalmic Center, Guangzhou, China, between January 1, 2006, and March 31, 2016. Results The inclusion criteria were met in 32 eyes of 29 patients. Molds were a common causative organism in 15 patients (51.7%), while yeasts appeared in 14 patients (48.3%). Initial visual acuity (VA) at the level of finger counting or better was significantly related to a good visual outcome (P = 0.002). Molds as a causative agent were significantly associated with worse visual outcome than yeasts (P = 0.020). Conclusion Molds were a common cause of culture-proven fungal endophthalmitis. Endogenous fungal endophthalmitis is generally associated with poor VA outcomes, especially if caused by molds and if the patient's initial VA is too low to permit finger counting.

[1]  Kaili Wu,et al.  Causative Microorganisms of Infectious Endophthalmitis: A 5-Year Retrospective Study , 2016, Journal of ophthalmology.

[2]  L. Gopal,et al.  Endogenous Endophthalmitis: A 10-Year Retrospective Study at a Tertiary Hospital in South India , 2015, Asia-Pacific journal of ophthalmology.

[3]  Janet Currie,et al.  Addressing Antibiotic Abuse in China: An Experimental Audit Study. , 2014, Journal of development economics.

[4]  Han Woong Lim,et al.  ENDOGENOUS ENDOPHTHALMITIS IN THE KOREAN POPULATION: A Six-Year Retrospective Study , 2014, Retina.

[5]  L. Mendoza,et al.  Etiological agents of fungal endophthalmitis: diagnosis and management , 2013, International Ophthalmology.

[6]  Ajay E. Kuriyan,et al.  Endogenous fungal endophthalmitis: risk factors, clinical features, and treatment outcomes in mold and yeast infections , 2013, Journal of Ophthalmic Inflammation and Infection.

[7]  S. Sinawat,et al.  Infectious endophthalmitis: review of 420 cases , 2013, Clinical ophthalmology.

[8]  Ming-Hui Sun,et al.  Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes. , 2012, American journal of ophthalmology.

[9]  Suhwan Lee,et al.  CHANGES IN THE CLINICAL FEATURES AND PROGNOSTIC FACTORS OF ENDOGENOUS ENDOPHTHALMITIS: Fifteen Years of Clinical Experience in Korea , 2012, Retina.

[10]  E. O'Neill,et al.  Endogenous endophthalmitis: 10-year experience at a tertiary referral centre , 2011, Eye.

[11]  Zhang,et al.  A comparison of pneumolysin activity and concentration in vitro and in vivo in a rabbit endophthalmitis model , 2008, Clinical ophthalmology.

[12]  Zhe-li Liu,et al.  Endogenous Endophthalmitis: A 10-year Review of Culture-positive Cases in Northern China , 2010, Ocular immunology and inflammation.

[13]  S. Hari,et al.  Culture Proven Endogenous Bacterial Endophthalmitis in Apparently Healthy Individuals , 2009, Ocular immunology and inflammation.

[14]  Gezhi Xu,et al.  Vitrectomy for Endogenous Fungal Endophthalmitis , 2009, Ocular immunology and inflammation.

[15]  R. Niederer,et al.  Infectious endophthalmitis: clinical features, management and visual outcomes , 2008, Clinical & experimental ophthalmology.

[16]  D. Selva,et al.  Endogenous endophthalmitis: A 13-year review at a tertiary hospital in South Australia , 2005, Scandinavian journal of infectious diseases.

[17]  H. Flynn,et al.  Culture-proven endogenous endophthalmitis: clinical features and visual acuity outcomes. , 2004, American journal of ophthalmology.

[18]  N. Rao,et al.  Endogenous Aspergillus endophthalmitis in an immunocompetent individual , 1993, International Ophthalmology.

[19]  P. Kaiser,et al.  Endogenous Endophthalmitis: An 18-Year Review of Culture-Positive Cases at a Tertiary Care Center , 2003, Medicine.

[20]  M. Rai,et al.  Endogenous endophthalmitis: case report and brief review. , 1999, American family physician.

[21]  R. Auckenthaler,et al.  Candida Colonization and Subsequent Infections in Critically III Surgical Patients , 1994, Annals of surgery.

[22]  C. Lowder,et al.  Endogenous endophthalmitis caused by Candida albicans in a healthy woman. , 1992, American journal of ophthalmology.

[23]  J. Band,et al.  The clinical spectrum of endophthalmitis: incidence, predisposing factors, and features influencing outcome. , 1990, The Journal of infectious diseases.

[24]  R. Diamond.  Inhibition of monocyte-mediated damage to fungal hyphae by steroid hormones. , 1983, The Journal of infectious diseases.

[25]  C. Puliafito,et al.  Infectious Endophthalmitis: Review of 36 Cases , 1982 .

[26]  A. Schaffner,et al.  Selective protection against conidia by mononuclear and against mycelia by polymorphonuclear phagocytes in resistance to Aspergillus. Observations on these two lines of defense in vivo and in vitro with human and mouse phagocytes. , 1982, The Journal of clinical investigation.