4.6 Article

Risk factors for ophthalmologic involvement and ocular findings in patients diagnosed with fungemia in a high-complexity hospital in the city of Medellin, Colombia

Journal

ANNALS OF MEDICINE
Volume 54, Issue 1, Pages 2204-2210

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/07853890.2022.2107700

Keywords

Fungemia; retina; candida; Fundus Oculi

Funding

  1. Department of Ophthalmology, Hospital Pablo Tobon Uribe, Medellin Antioquia
  2. Universidad Pontificia Bolivariana

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This study aims to describe the demographic clinical characteristics of patients with fungemia and secondary intraocular involvement, and identify risk factors. The findings suggest that there is no clear risk factor for subsequent ocular involvement in patients with fungemia, but patients with diabetes and history of HIV may have a risk trend.
Purpose To describe the demographic clinical characteristics and to identify the risk factors of patients diagnosed with fungemia and secondary intraocular involvement. Methods Retrospective cohort of 97 patients diagnosed with fungemia and with or without involvement of the posterior segment. Demographic, clinical and ophthalmological variables were identified to establish the risk of retinal seeding. Results An incidence of ocular involvement of 22.68% was obtained and no clear risk factor was found for subsequent showings in patients with fungemia. A risk trend was only found in patients with diabetes with an OR: 2.85; CI 95%: (0.80-10.12) and history of HIV with an OR: 2.29 CI95%: (0.85-6.12). Conclusions In this first cohort carried out in Colombia according to our search, findings were obtained that agree with those of other authors worldwide, where there is no evidence of a decrease in incidence compared with older studies and the absence of risk factors for the compromise of the posterior pole in patients with fungemia. KEY MESSAGES Systematic fundus evaluation by an ophthalmologist in patients with candidaemia is a recommended practice based on low-quality evidence. The identification of real risk factors for retinal compromise in fungemia would allow us to be more selective with the population to be evaluated. Fungemia generally occurs in critically ill patients, where access and availability of ophthalmology evaluation are a resource that is not always available.

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