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2014 Agenda and Abstracts | < Previous | Next >

2014 OMIG Abstract 12

Endogenous Fungal Endophthalmitis in Intravenous Drug Abusers:
Is the Incidence on the Rise?

Henry D Holt, David M Hinkle, Angela K Au, Naomi S Falk and Pawan Bhatnagar
Lions Eye Institute, Slingerlands, NY

Purpose: To describe the diagnostic and therapeutic challenges of managing an outbreak of Endogenous Fungal Endophthalmitis (EFE) associated with intravenous drug abuse (IVDA).

Methods: A retrospective chart review to identify all cases of EFE encountered at our institution from 1/1/2004 until 12/31/2014 was performed. Data collected in collaboration with the New York State Health Department included demographic information, etiology of endophthalmitis, presenting features, time from presentation to diagnosis, treatment course and visual outcome.

Results: Nine eyes of 8 patients were identified during 2013 and one eye of 1 patient was identified from 2004-2012. Initial vitreous biopsy, when performed, was negative. Seven of 9 patients required vitrectomy.  Candida species were cultured or identified in 3 of 9 specimens in which centrifugation was performed. Early initiation of empiric antifungal therapy was associated with more favorable visual outcomes. One case of Aspergillus endophthalmitis in which diagnosis was delayed required enucleation.

Conclusion: Intravenous drug abuse is on the rise in the United States and may account for the increased number of EFE cases encountered at our institution. When treating endophthalmitis in at risk individuals a high index of suspicion, centrifugation of vitreous specimens and empiric antifungal therapy may improve diagnostic yield, reduce delay in diagnosis, and improve visual outcomes.
Disclosure: N

2014 Agenda and Abstracts | < Previous | Next >