Wednesday, January 20, 2010

Candida Endopthalmitis

We've talked about candidemia before...

One of the complications of candidemia is the development of endogenous endopthalmitis. Different rates of occular involvement are quoted from 2%-40% depending on case series.

The majority of patients will develop endopthamitis within 2 weeks of candidemia. Particularly if there is a delay in treatment of the candidemia or if the candidemia is protracted.

Early retinal exam can diagnosis, but follow up at 2 weeks is prudent as early lesions can be missed.

Treatment is covered in the IDSA guidelines (previously cited). Azole agents can be used for succeptible isolates. If there is a significant vitritis, sometimes vitrectomy with intraoccular amphotericin is required in addition to systemic therapy.

There are a number of good reviews here (treatment), here (case report and review of condition), here (BMJ review) and here (retinal lesions in sepsis, including description of occular manifestations).

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