634. Incidence and Predictors of Ocular Candidiasis After Fungemia
Session: Abstracts: Mycology
Friday, October 22, 2010
Background: The reported incidence of chorioretinitis or endophthalmitis following fungemia due to Candida species is variable and ranges from 2-45%.  The aim of this study was to determine the incidence and the risk factors of ocular candidiasis.

Methods: We retrospectively reviewed the charts of all patients diagnosed with candidemia at the University of Kansas Medical Center between January 2005 and March 2010. Data regarding patients’ demographics, clinical characteristics, laboratory results, and ophthalmology findings were collected.

Results: During the study period, a total of 200 patients were diagnosed with candidemia. Only 118 (62%) were evaluated by ophthalmology. The mean age (± standard deviation) of the latter group was 52 (± 18) years; 68% were male. Evidence of ocular candidiasis was present in 17 (14.4%) patients. Visual symptoms were reported by 4 out of 17 patients. The most commonly isolated Candida species from the blood were C. albicans (44.5 %), C. parapsilosis (21.5%), C. glabrata (19%), and C. tropicalis (9.5%). In multivariate analysis, previous intravenous drug abuse (IVDA) (p=0.003) and C. albicans fungemia (p=0.027) were significantly associated with intraocular infection. Patients with history of malignancy (p=0.13) and positive central venous catheter tip culture (p=0.18) showed a trend towards higher risk of ocular candidiasis.

Conclusion: History of IVDA and C. albicans fungemia were the only predictors of ocular candidiasis in patients with candidemia. Visual symptoms are usually absent and therefore all patients with candidemia should undergo fundoscopic examination to rule out intraocular infection.


Subject Category: M. Mycology including clinical and basic studies of fungal infections

Speakers:
Ayesha Khalid, MD , Infectious Diseases, University of Kansas medical Center, Kansas City, KS
Albert Eid, MD , Infectious Diseases, University of Kansas Medical Center, Kansas City, KS
Lisa Clough, MD , Infectious Diseases, University of Kansas Medical Center, kansas City, KS

Disclosures:

A. Khalid, None

A. Eid, None

L. Clough, None

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