Endogenous Fungal Endophthalmitis Associated with Genitourinary Procedures

Ocul Immunol Inflamm. 2019;27(5):747-755. doi: 10.1080/09273948.2018.1465100. Epub 2018 Jul 11.

Abstract

Purpose: To summarize the characteristics of endogenous fungal endophthalmitis (EFE) after genitourinary procedures. Methods: Medical records of patients diagnosed with EFE after genitourinary procedures from a single center during a 6-year period were reviewed. Results: Nineteen eyes of 15 patients were included. The interval time between procedure to symptom was 3.6 ± 3.6 weeks. As the initial treatment, 9/19 eyes underwent primary vitrectomy and 10/19 eyes underwent intravitreal antifungal injection . Candida albicans was the pathogen in 15 of 19 eyes. Systemic treatment with itraconazole was used in all patients. LogMAR best corrected visual acuity improved from 2.2 ± 0.9 to 0.9 ± 1.2 after treatment (p = 0.002) in 15 eyes that were followed-up for an average of 4.9 ± 2.1 years. Conclusion: Genitourinary procedure is a predisposing factor for EFE. Candida albicans is the predominant pathogen. Normative systemic and local antifungal treatments improved the final visual outcome.

Keywords: Causative organism; endogenous; fungal endophthalmitis; genitourinary procedure; predisposing risk factors.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Antifungal Agents / therapeutic use
  • Endophthalmitis / drug therapy
  • Endophthalmitis / etiology*
  • Endophthalmitis / microbiology
  • Eye Infections, Fungal / drug therapy
  • Eye Infections, Fungal / etiology*
  • Eye Infections, Fungal / microbiology
  • Female
  • Female Urogenital Diseases / surgery*
  • Humans
  • Male
  • Male Urogenital Diseases / surgery*
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Substances

  • Antifungal Agents