176. Ocular Candidiasis in Patients with Candidemia at a Large Tertiary Care Center
Session: Poster Abstract Session: Clinical Mycology
Thursday, October 5, 2017
Room: Poster Hall CD

Background:

Bloodstream infections (BSI) caused by Candida sp. have a high mortality rate and have been increasing in recent years. Ocular candidiasis (OC) is one systemic manifestation of Candida infection; either chorioretinitis or endophthalmitis, and may lead to vision loss. Therefore, IDSA recommends an ophthalmology exam for all patients with Candida BSI. However, reported incidence of OC varies from 1-25%, questioning routine eye exams in these patients. The purpose of this study is to evaluate the number of patients who undergo ophthalmological exams and those diagnosed with OC at Ochsner Medical Center, New Orleans (OMC-NO).

Methods:

144 patients were identified from January 2013-December 2015 with at least one positive blood culture for Candida sp (only albicans, glabrata, and parapsilosis were included). Records were reviewed through the EPIC system.

Results:

Of the 144 patients, 65 were females and 79 males; average age 58 years old. 76 (52.8%) had an ophthalmological exam at Ochsner; excluding 1 patient who refused an exam, 1 patient who was excessively combative, and 1 patient in whom exam was deferred due to medical condition. 3 patients (3.9%) showed Candida chorioretinitis; none endophthalmitis.

Conclusion:

OC can have devastating consequences if left untreated and early diagnosis is imperative. Our analysis reveals that OC is present in 3.9% of ophthalmology exams, but this may be biased towards patients who are cooperative and can tolerate a dilated eye exam. Critical patients with multiple co-morbidities may be at higher risk for OC. A weakness of our study is that it is limited to ophthalmology records at Ochsner, and there may be records at outside facilities.  Further data is required to make recommendations in patients with Candida BSI.

Bonny Lee, MD1, Lydia Breskin, MS2, Laya Reddy, MD3, Alessandro Iliceto, BLA4, Deborah Ashcraft, BS5, George Pankey, MD, FIDSA5, Jonathan Nussdorf, MD1 and Julia Garcia-Diaz, MD, FIDSA6, (1)Ochsner Clinic Foundation, New Orleans, LA, (2)Tulane University School of Medicine, New Orleans, LA, (3)University of Queensland/Ochsner Clinical School, Jefferson, LA, (4)University of Queensland, Ochsner Clinical School, New Orleans, LA, (5)Infectious Disease Translational Research, Ochsner Clinic Foundation, New Orleans, LA, (6)Infectious Diseases, Ochsner Clinic Foundation, New Orleans, LA

Disclosures:

B. Lee, None

L. Breskin, None

L. Reddy, None

A. Iliceto, None

D. Ashcraft, None

G. Pankey, None

J. Nussdorf, None

J. Garcia-Diaz, None

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