Endogenous Fungal Endophthalmitis following COVID-19 Hospitalization : Evidence from a Year-Long Observational Study
Copyright © 2023 Elsevier Masson SAS. All rights reserved..
PURPOSE: To describe cases of endogenous fungal endophthalmitis (EFE) post-recovery from or hospitalization for coronavirus disease 2019 (COVID-19).
METHODS: This prospective audit involved patients with suspected endophthalmitis referred to a tertiary eye care center over a one-year period. Comprehensive ocular examinations, laboratory studies, and imaging were performed. Confirmed cases of EFE with a recent history of COVID-19 hospitalization±intensive care unit admission were identified, documented, managed, followed up, and described.
RESULTS: Seven eyes of six patients were reported; 5/6 were male, and the mean age was 55. The mean duration of hospitalization for COVID-19 was approximately 28 days (14-45); the mean time from discharge to onset of visual symptoms was 22 days (0-35). All patients had underlying conditions (5/6 hypertension; 3/6 diabetes mellitus; 2/6 asthma) and had received dexamethasone and remdesivir during their COVID-related hospitalization. All presented with decreased vision, and 4/6 complained of floaters. Baseline visual acuity ranged from light perception (LP) to counting fingers (CF). The fundus was not visible in 3 out of 7 eyes; the other 4 had "creamy-white fluffy lesions" at the posterior pole as well as significant vitritis. Vitreous taps were positive for Candida species in six and Aspergillus species in one eye. Anti-fungal treatment included intravenous amphotericin B followed by oral voriconazole and intravitreal amphotericin B. Three eyes underwent vitrectomy; the systemic health of two patients precluded surgery. One patient (with aspergillosis) died; the others were followed for 7-10 months - the final visual outcome improved from CF to 20/200-20/50 in 4 eyes and worsened (hand motion to LP) or did not change (LP), in two others.
CONCLUSION: Ophthalmologists should maintain a high index of clinical suspicion for EFE in cases with visual symptoms and a history of recent COVID-19 hospitalization and/or systemic corticosteroid use - even without other well-known risk factors.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:46 |
|---|---|
| Enthalten in: |
Journal francais d'ophtalmologie - 46(2023), 5 vom: 06. Mai, Seite 461-467 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Fekri, S [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
7XU7A7DROE |
|---|
| Anmerkungen: |
Date Completed 31.05.2023 Date Revised 31.05.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jfo.2022.12.002 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM353957976 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM353957976 | ||
| 003 | DE-627 | ||
| 005 | 20231226061201.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jfo.2022.12.002 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1179.xml |
| 035 | |a (DE-627)NLM353957976 | ||
| 035 | |a (NLM)36890074 | ||
| 035 | |a (PII)S0181-5512(23)00093-1 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Fekri, S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Endogenous Fungal Endophthalmitis following COVID-19 Hospitalization |b Evidence from a Year-Long Observational Study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 31.05.2023 | ||
| 500 | |a Date Revised 31.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a PURPOSE: To describe cases of endogenous fungal endophthalmitis (EFE) post-recovery from or hospitalization for coronavirus disease 2019 (COVID-19) | ||
| 520 | |a METHODS: This prospective audit involved patients with suspected endophthalmitis referred to a tertiary eye care center over a one-year period. Comprehensive ocular examinations, laboratory studies, and imaging were performed. Confirmed cases of EFE with a recent history of COVID-19 hospitalization±intensive care unit admission were identified, documented, managed, followed up, and described | ||
| 520 | |a RESULTS: Seven eyes of six patients were reported; 5/6 were male, and the mean age was 55. The mean duration of hospitalization for COVID-19 was approximately 28 days (14-45); the mean time from discharge to onset of visual symptoms was 22 days (0-35). All patients had underlying conditions (5/6 hypertension; 3/6 diabetes mellitus; 2/6 asthma) and had received dexamethasone and remdesivir during their COVID-related hospitalization. All presented with decreased vision, and 4/6 complained of floaters. Baseline visual acuity ranged from light perception (LP) to counting fingers (CF). The fundus was not visible in 3 out of 7 eyes; the other 4 had "creamy-white fluffy lesions" at the posterior pole as well as significant vitritis. Vitreous taps were positive for Candida species in six and Aspergillus species in one eye. Anti-fungal treatment included intravenous amphotericin B followed by oral voriconazole and intravitreal amphotericin B. Three eyes underwent vitrectomy; the systemic health of two patients precluded surgery. One patient (with aspergillosis) died; the others were followed for 7-10 months - the final visual outcome improved from CF to 20/200-20/50 in 4 eyes and worsened (hand motion to LP) or did not change (LP), in two others | ||
| 520 | |a CONCLUSION: Ophthalmologists should maintain a high index of clinical suspicion for EFE in cases with visual symptoms and a history of recent COVID-19 hospitalization and/or systemic corticosteroid use - even without other well-known risk factors | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Dexamethasone | |
| 650 | 4 | |a Dexaméthasone | |
| 650 | 4 | |a Endophtalmie | |
| 650 | 4 | |a Endophthalmitis | |
| 650 | 4 | |a Fongémie | |
| 650 | 4 | |a Fungemia | |
| 650 | 4 | |a Hospitalisation | |
| 650 | 4 | |a Hospitalization | |
| 650 | 7 | |a Amphotericin B |2 NLM | |
| 650 | 7 | |a 7XU7A7DROE |2 NLM | |
| 650 | 7 | |a Voriconazole |2 NLM | |
| 650 | 7 | |a JFU09I87TR |2 NLM | |
| 700 | 1 | |a Khorshidifar, M |e verfasserin |4 aut | |
| 700 | 1 | |a Esfahanian, F |e verfasserin |4 aut | |
| 700 | 1 | |a Veisi, A |e verfasserin |4 aut | |
| 700 | 1 | |a Nouri, H |e verfasserin |4 aut | |
| 700 | 1 | |a Abtahi, S-H |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal francais d'ophtalmologie |d 1993 |g 46(2023), 5 vom: 06. Mai, Seite 461-467 |w (DE-627)NLM000357944 |x 1773-0597 |7 nnns |
| 773 | 1 | 8 | |g volume:46 |g year:2023 |g number:5 |g day:06 |g month:05 |g pages:461-467 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jfo.2022.12.002 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 46 |j 2023 |e 5 |b 06 |c 05 |h 461-467 | ||