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Asao K, Hashida N, Maruyama K, Motooka D, Nakamura S, Nishida K. Cases of endophthalmitis caused by Candida albicans and Candida dubliniensis identified via internal transcribed spacer deep sequencing. BMC Ophthalmol 2024; 24:444. [PMID: 39385149 PMCID: PMC11463106 DOI: 10.1186/s12886-024-03702-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 09/26/2024] [Indexed: 10/11/2024] Open
Abstract
BACKGROUND We report two cases of fungal endophthalmitis induced by Candida species identified based on internal transcribed spacer 1 (ITS1) sequencing. CASE PRESENTATION In two cases, endophthalmitis was suspected, and the patients underwent pars plana vitrectomy. Case 1 was a 64-year-old woman with a history of cataract surgery 10 days prior. She had a history of anal primary melanoma, which metastasized throughout the body and subsequently relapsed. Vitreous culture and ITS-1 deep sequencing revealed the presence of the rare fungus, Candida dubliniensis. Case 2 was a 54-year-old man with a history of liver cancer and kidney failure. Culture methods and ITS1 deep sequencing both revealed the presence of Candida albicans. Both patients exhibited good visual prognoses after treatment with topical and systemic antibiotics. CONCLUSIONS We present two cases of fungal endophthalmitis caused by two Candida species identified by both the culture method and ITS1 deep sequencing. The fungal pathogen was identified by ITS deep sequencing three days after sample submission; the culture method yielded results after 1 week. These findings support the applicability of ITS1 sequencing for timely pathogen identification for cases of fungal endophthalmitis and provide detailed taxonomic information at the species level.
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Affiliation(s)
- Kazunobu Asao
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan.
| | - Noriyasu Hashida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Kazuichi Maruyama
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
- Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Motooka
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Shota Nakamura
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University Graduate School of Medicine, Osaka, Japan
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Abrishami M, Abrishami M, Hatami N, Shoeibi N, Hosseini SM, Ansari Astaneh MR, Bakhtiari E, Motamed Shariati M. Clinical characteristics and management outcome of acute infectious endophthalmitis. Int Ophthalmol 2024; 44:308. [PMID: 38958789 DOI: 10.1007/s10792-024-03239-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE This study aimed to investigate the demographics, clinical characteristics, and management outcomes of patients with acute infectious endophthalmitis (AIE). METHODS This retrospective chart review was conducted on all patients admitted with the clinical diagnosis of infectious endophthalmitis from 2017 to 2022. Demographic data, patients' clinical characteristics, the type of acute infectious endophthalmitis (post-operative, post-traumatic, bleb-associated, and endogenous endophthalmitis), the type of surgical procedure in the post-operative cases, the microbiologic analysis results of vitreous samples, therapeutic measures, and visual outcomes of patients were recorded. RESULTS In this study, 182 participants, including 122 male (67%) and 60 (33%) female, were involved. The mean age of patients was 54.56 ± 21 years, with a range of 1-88 years old. The most prevalent type of AIE was post-operative (59.9%), followed by endogenous (19.2%), post-traumatic (17%), and bleb-associated (3.8%). The most common type of intraocular surgery in the post-operative subgroups of AIE patients was phacoemulsification (57.8%). The median (interquartile range) of the primary and final BCVA of patients was 1.5 (1.35, 1.85) and 0.65 (0.35, 1.35), respectively. Vitreous haziness grade (OR, 2.89; 95% CI, 1.11-5.74; p = 0.009) and the primary VA (OR, 60.34; 95% CI, 2.87-126.8; p = 0.008) revealed statistical significance for final vision loss. CONCLUSION AIE is a devastating condition with poor visual outcomes, which presents with acute inflammatory signs and symptoms regardless of its type. However, prompt and appropriate treatment leads to visual recovery to a functional level in many patients.
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Affiliation(s)
- Mojtaba Abrishami
- Eye Research Center, Khatam Al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Gharani Boulevard, Mashhad, Iran
- Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Canada
| | - Majid Abrishami
- Eye Research Center, Khatam Al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Gharani Boulevard, Mashhad, Iran
| | - Nahid Hatami
- Eye Research Center, Khatam Al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Gharani Boulevard, Mashhad, Iran
| | - Nasser Shoeibi
- Eye Research Center, Khatam Al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Gharani Boulevard, Mashhad, Iran
| | - Seyedeh Maryam Hosseini
- Eye Research Center, Khatam Al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Gharani Boulevard, Mashhad, Iran
| | - Mohammad Reza Ansari Astaneh
- Eye Research Center, Khatam Al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Gharani Boulevard, Mashhad, Iran
| | - Elham Bakhtiari
- Eye Research Center, Khatam Al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Gharani Boulevard, Mashhad, Iran
| | - Mehrdad Motamed Shariati
- Eye Research Center, Khatam Al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Gharani Boulevard, Mashhad, Iran.
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Lee CY, Sheu SJ, Chen SN, Cheng CK, Kuo HK, Hwang DK, Lai CH, Chan WC, Hsieh YT, Yang CH. Literature- and Experience-Based Consensus for Acute Post-operative Endophthalmitis and Endogenous Endophthalmitis in Taiwan. Ophthalmol Ther 2024; 13:1-19. [PMID: 37934385 PMCID: PMC10776529 DOI: 10.1007/s40123-023-00835-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Clinical practices on acute post-operative and endogenous endophthalmitis (EnE) are highly variable among clinicians due to a lack of up-to-date, high-quality evidential support. An expert consensus is thus much needed. A panel consisting of ten retinal specialists in Taiwan was organized. They evaluated relevant literature and developed key questions regarding acute post-operative and EnE that are cardinal for practice but yet to have conclusive evidence. The panel then attempted to reach consensus on all the key questions accordingly. There were eight key questions proposed and their respective consensus statements were summarized as follows: Gram staining and culture are still the standard procedures for the diagnosis of endophthalmitis. Vitrectomy is recommended to be performed earlier than the timing proposed by the Endophthalmitis Vitrectomy Study (EVS). Routine intracameral antibiotic injection for post-cataract surgery endophthalmitis prophylaxis is not recommended because of potential compounding error hazards and a lack of support from high-quality studies. Routine fundus examination is recommended for all patients with pyogenic liver abscess. In EnE, vitrectomy is recommended if diffused and dense vitritis is present, or if the disease progresses. These consensus statements may work as handy guidance or reference for clinical practices of acute post-operative and EnE.
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Affiliation(s)
- Cheng-Yung Lee
- Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Hospital, No. 25, Ln. 442, Sec. 1, Jingguo Road, North District, Hsinchu City, 300, Taiwan (ROC)
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City, 100225, Taiwan (ROC)
- Department of Ophthalmology, National Taiwan University College of Medicine, No. 1 Jen-Ai Road Section 1, Taipei, 100, Taiwan (ROC)
| | - Shwu-Jiuan Sheu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, No. 100, Tzyou 1St Road, Sanmin Dist., Kaohsiung City, 80756, Taiwan (ROC)
- School of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung City, 80708, Taiwan
| | - San-Ni Chen
- Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, No. 2, Yude Road, North District, Taichung City, 404327, Taiwan (ROC)
- School of Medicine, College of Medicine, China Medical University, No. 91 Hsueh-Shih Road, Taichung City, 404333, Taiwan
| | - Cheng-Kuo Cheng
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, No. 95, Wenchang Road, Shilin District, Taipei, 111045, Taiwan
- School of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City, 242062, Taiwan (ROC)
| | - Hsi-Kung Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Road, Niaosong District, Kaohsiung City, 833401, Taiwan
| | - De-Kuang Hwang
- School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong Street, Beitou District, Taipei, 112304, Taiwan (ROC)
- Department of Ophthalmology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11217, Taiwan
| | - Chien-Hsiung Lai
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, No.6, Sec. W., Jiapu Road, Puzi City, 613, Chiayi County, Taiwan (ROC)
- Department of Ophthalmology, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City, 33302, Taiwan (ROC)
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, No.2, Sec. W., Jiapu Road, Puzi City, 61363, Chiayi County, Taiwan (ROC)
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City, 33302, Taiwan (ROC)
| | - Wei-Chun Chan
- Department of Ophthalmology, Mackay Memorial Hospital, No. 92, Sec.2, Chung-Shan North Road, Taipei, Taiwan
| | - Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City, 100225, Taiwan (ROC)
- Department of Ophthalmology, National Taiwan University College of Medicine, No. 1 Jen-Ai Road Section 1, Taipei, 100, Taiwan (ROC)
| | - Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City, 100225, Taiwan (ROC).
- Department of Ophthalmology, National Taiwan University College of Medicine, No. 1 Jen-Ai Road Section 1, Taipei, 100, Taiwan (ROC).
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