Brooks R G
Department of Internal Medicine, Orlando Regional Medical Center, Fla.
Arch Intern Med. 1989 Oct;149(10):2226-8.
To determine the frequency of endogenous Candida endophthalmitis in patients with candidemia, we prospectively evaluated 32 inpatients with fungemia by weekly indirect ophthalmoscopic examinations. Chorioretinitis compatible with Candida infection was found in 9 (28%) patients. Patient age, sex, underlying diseases, or hospital-acquired factors, such as presence of central venous or Foley catheters, bacteremia, use of multiple antibiotics, hyperalimentation, or surgery, did not distinguish between groups. Groups were also similar in number of sites colonized with yeast and species of Candida recovered. Patients with endophthalmitis tended to have more blood cultures positive for Candida (mean, 4.3) than the patients without endophthalmitis (mean, 2.8), but this trend did not reach statistical significance. Based on these results, we recommend periodic ophthalmoscopic examinations in all patients with documented candidemia.
为确定念珠菌血症患者中内源性念珠菌性眼内炎的发生率,我们通过每周一次的间接检眼镜检查对32例真菌血症住院患者进行了前瞻性评估。9例(28%)患者发现有与念珠菌感染相符的脉络膜视网膜炎。患者的年龄、性别、基础疾病或医院获得性因素,如中心静脉导管或Foley导尿管的存在、菌血症、多种抗生素的使用、胃肠外营养或手术等,在两组之间并无差异。两组在酵母定植部位数量及分离出的念珠菌种类方面也相似。与无眼内炎的患者相比,眼内炎患者的血培养念珠菌阳性次数往往更多(平均4.3次 vs 平均2.8次),但这一趋势未达到统计学意义。基于这些结果,我们建议对所有确诊为念珠菌血症的患者进行定期检眼镜检查。