Govindaraju Viren K, Chao Jonathan T, Duvall Elizabeth R, Baker Nicolas S, Fahey Kelly M, Lee Ramon, Williams George A, Stec Lori A
Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
Department of Vitreoretinal Surgery, Associated Retinal Consultants, Royal Oak, MI, USA.
Clin Ophthalmol. 2022 Aug 22;16:2743-2750. doi: 10.2147/OPTH.S362888. eCollection 2022.
Endogenous endophthalmitis is a severe intraocular infectious condition requiring rapid diagnosis and treatment. This study examines the incidence of fungal endophthalmitis in patients with elevated beta-D-glucan (BG) levels and those with positive blood culture and the utility of ophthalmology consultation in these patients.
Single center retrospective consecutive cohort study was conducted on patients at Beaumont Health from 2016-2021 who either had positive fungal blood cultures or an elevated BG level.
A total of 147 patients were examined by the ophthalmology department where 30 patients had an elevated BG level and 100 patients had a positive fungal blood culture. Incidence of fungal endophthalmitis was 0% in the elevated BG group and 1.5% in the positive fungal culture group, corresponding to a relative risk ratio of 0.0 (p = 0.31).
BG testing may be useful in diagnosing isolated cases outside the standard screening paradigm, however the data within this study support the conclusion that there is no compelling evidence at this time to add or use BG as a surrogate for endophthalmitis screening. Further studies are required to further elucidate the role of BG in the care of critically ill patients.
内源性眼内炎是一种严重的眼内感染性疾病，需要快速诊断和治疗。本研究调查了β-D-葡聚糖（BG）水平升高的患者和血培养阳性的患者中真菌性眼内炎的发生率，以及眼科会诊在这些患者中的作用。
对2016年至2021年在博蒙特健康中心就诊的患者进行了单中心回顾性连续队列研究，这些患者要么真菌血培养呈阳性，要么BG水平升高。
眼科共检查了147例患者，其中30例患者BG水平升高，100例患者真菌血培养呈阳性。BG水平升高组真菌性眼内炎的发生率为0%，真菌培养阳性组为1.5%，相对风险比为0.0（p = 0.31）。
BG检测可能有助于诊断标准筛查模式以外的孤立病例，然而本研究中的数据支持以下结论：目前没有令人信服的证据表明应添加或使用BG作为眼内炎筛查的替代指标。需要进一步研究以进一步阐明BG在重症患者护理中的作用。
