A lthough the number of cataract surgery procedures is increasing globally because of an aging population, the incidence of postoperative endophthalmitis is declining because hygiene and surgical environments have improved (1,2). Postsurgical fungal endophthalmitis is difficult to diagnose because symptoms, such as decreased vision and eye pain, are nonspecific (3). Most cases of postoperative endophthalmitis are caused by bacteria, and ≈75% occur within 1 week after surgery (4). Because the symptoms of bacterial and fungal endophthalmitis are similar, intraocular fluid culture is crucial for an accurate diagnosis (5). Preventing serious complications such as vision loss requires immediate diagnosis, vitrectomy, and long-term antifungal therapy (6,7).Postoperative endophthalmitis rarely occurs in South Korea; only ≈63 cases are reported per 100,000 cataract surgeries (8). However, the Korean Ophthalmological Society (KOS) recognized a sudden increase in endophthalmitis cases after cataract surgeries during September-November 2020, when ≈100 cases were reported nationwide. Cases included clinical findings of fungal endophthalmitis, including isolation of Fusarium species. Thus, in November 2020, KOS informed the Korea Disease Control Agency (KDCA), which promptly collaborated with the Korea Ministry of Food and Drug Safety (KMFDS) to investigate the unusual increase in fungal endophthalmitis, identify the cause, and recommend control measures.During the epidemiologic investigation, KMFDS collected commercially available samples of ocular viscoelastic devices (OVDs) from 6 manufacturers to conduct quality testing. OVDs are substances injected under the cornea to maintain the shape of the eye during cataract surgery and remain in the eyeball until the last step of surgery, when the OVD is removed. Thus, contaminated OVDs can cause intraocular infection. We describe an outbreak of fungal endophthalmitis after cataract surgery and confirmation of the cause through epidemiologic and microbiologic investigations. Materials and Methods Outbreak DeterminationTo determine whether the cases reported by KOS could be classified as an outbreak, KDCA analyzed data from Health Insurance Review and Assessment
Colorectal cancer (CRC) is the third most common cancer in Korea. Its average growth rate has been 3.7% annually from 1999 to 2013. The 5-year relative survival rate is 75.6%. The number of CRC survivors is expected to increase steadily because of its high incidence and survival rate. Because CRC survivors are at risk for recurrence, metachronous cancer, and other cancers, they should be checked regularly. Recommended surveillance includes history-taking and physical examination, colonoscopy, carcinoembryonic antigen testing, and computed tomography. Routine complete blood counts, liver function test, and positron emission tomography are not recommended. CRC survival, which is associated with Lynch syndrome and familial adenomatous polyposis, is also related to a higher risk of other cancers such as gastrointestinal and gynecologic cancers. Additional surveillance should be taken. CRC survivors could complain of general health problems such as cancer-related fatigue and psychosocial/cognitive dysfunction, in addition to treatment-related problems including bowel/urologic/sexual dysfunction, peripheral neuropathy, and ostomy care. They are also at greater risk of cardiovascular diseases. The primary care physician should counsel CRC survivors about their health problems and make an effort to address these concerns. Primary care physicians should try to communicate with CRC survivors and all specialists for clinical follow-up care.
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