Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan.
Diagn Microbiol Infect Dis. 2012 Jun;73(2):149-52. doi: 10.1016/j.diagmicrobio.2012.03.006. Epub 2012 Apr 12.
Ocular candidiasis is a major complication of Candida bloodstream infection (BSI). This study was performed to reveal the clinical characteristics of ocular candidiasis. Of the 220 patients with Candida BSI, 204 cases received ophthalmology consultations between January 2005 and December 2011 at 2 teaching hospitals. Fifty-four (26.5%) cases had findings consistent with the diagnosis of ocular candidiasis. Of these 54 cases, 43 (79.6%) were diagnosed within 7 days after a positive blood culture. Among ocular candidiasis cases, more cases were due to Candida albicans (P =0.034 odds ratio [OR]; 3.68 95% confidence interval [CI] 1.11-12.2) and had higher β-d-glucan values (P = 0.001 OR; 9.99 95% CI 2.60-21.3). We need to consider fundoscopic examination to be performed within the first 7 days of therapy, especially for those patients who have C. albicans BSIs and higher β-d-glucan values. Additionally, follow-up fundoscopic examination should be considered before stopping therapy for high-risk patients.
眼念珠菌病是念珠菌血流感染（BSI）的主要并发症。本研究旨在揭示眼念珠菌病的临床特征。在 2005 年 1 月至 2011 年 12 月期间，2 所教学医院对 220 例念珠菌 BSI 患者进行了眼科会诊，其中 54 例（26.5%）符合眼念珠菌病的诊断。这 54 例中，43 例（79.6%）在血培养阳性后 7 天内确诊。在眼念珠菌病病例中，更多病例是由白色念珠菌引起（P=0.034 比值比 [OR]；3.68 95%置信区间 [CI] 1.11-12.2），β-d-葡聚糖值更高（P=0.001 OR；9.99 95% CI 2.60-21.3）。我们需要考虑在治疗的前 7 天内进行眼底检查，特别是对于那些有白色念珠菌 BSI 和更高的β-d-葡聚糖值的患者。此外，对于高危患者，在停止治疗之前应考虑进行随访眼底检查。
