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眼科会诊以发现内源性眼内炎:高危住院患者中会诊病例与确诊病例的临床特征。

Ophthalmology Consultation to Detect Endogenous Endophthalmitis: Clinical Characteristics in Consulted Versus Diagnosed Cases Among At-Risk Inpatients.

出版信息

Ophthalmic Surg Lasers Imaging Retina. 2020 Mar 1;51(3):159-A3. doi: 10.3928/23258160-20200228-05.

DOI:10.3928/23258160-20200228-05
PMID:32211906
Abstract

BACKGROUND AND OBJECTIVE

Predisposing factors for ophthalmology consultations and endogenous endophthalmitis were compared among inpatients with systemic infection.

PATIENTS AND METHODS

This was a retrospective cohort study in a tertiary care hospital between January 1, 2010, and December 31, 2014. Multivariable logistic regression was utilized.

RESULTS

There were 9,527 encounters identified with systemic infection. The 5-year incidence rate was 8.4% (803/9,527) for consultations and 0.3% (25/9,527) for endophthalmitis. Factors most associated with consultations included positive fungal blood cultures and HIV. Factors most associated with endophthalmitis included positive blood fungal cultures and endocarditis. Four of 25 endophthalmitis patients lacked positive blood cultures; six of 20 endophthalmitis patients with adequate mentation were asymptomatic.

CONCLUSIONS

Positive blood fungal cultures were strongly associated with both endophthalmitis and consultations. Endocarditis was strongly associated with endophthalmitis but less associated with consultation and may warrant increased attention. Neither presence of symptoms nor positive cultures may be sufficiently accurate to determine need for consultation. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:159-169.].

摘要

背景与目的

比较患有全身感染的住院患者的眼科会诊和内源性眼内炎的诱发因素。

患者与方法

这是一家三级保健医院在 2010 年 1 月 1 日至 2014 年 12 月 31 日期间进行的回顾性队列研究。采用多变量逻辑回归。

结果

共发现 9527 例全身感染患者。5 年的会诊发生率为 8.4%(803/9527),眼内炎发生率为 0.3%(25/9527)。与会诊最相关的因素包括阳性真菌血培养和 HIV。与眼内炎最相关的因素包括阳性血液真菌培养和心内膜炎。25 例眼内炎患者中有 4 例缺乏阳性血液培养;20 例有足够意识的眼内炎患者中有 6 例无症状。

结论

阳性血液真菌培养与眼内炎和会诊均密切相关。心内膜炎与眼内炎密切相关,但与会诊的相关性较低,可能需要更多关注。有症状或无阳性培养均可能不足以确定会诊的必要性。

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