Endogenous fungal endopthalmitis treated with intravitreal caspofungin in a COVID-19 recovered patient: A case report

Nakhwa, Chinmay

doi:10.4103/ijo.ijo_1192_21

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Amphotericin B and voriconazole are commonly used antifungal agents and have exhibited favorable effects in controlling inflammation ( Yang et al., 2011 ; Bae and Lee, 2015 ; Zhao et al., 2015 ; Bienvenu et al., 2020 ). What’s more, several case reports published in recent years have shown that in the cases of resistant fungal endophthalmitis, intravitreal caspofungin, the first approved antifungal echinocandin, can be an ideal and safe alternative to the former two ( Danielescu et al., 2017 ; Yadav et al., 2017 ; Von Jagow et al., 2020 ; Nakhwa, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Endophthalmitis: a bibliometric study and visualization analysis from 1993 to 2023

Fu,

Du,

Huang

et al. 2024

Front. Cell. Infect. Microbiol.

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AimsThis study is designed to generalize and depict the research hotspots of endophthalmitis through bibliometric methods and software and analyze the evolutive tendency of the work on this severe disease over the past 30 years.MethodsThis study employed a rigorous bibliometric approach. We identified all endophthalmitis-related literature by conducting a comprehensive search of the Science Citation Index Expanded database under the Web of Science Core Collection. The data was then analyzed and visualized using CiteSpace and VOSviewer, two widely recognized software tools in the field of bibliometrics. CiteSpace was used to analyze the country distributions, dual map overlay of journals, keyword bursts, and co-cited references. VOSviewer was employed to describe the authors and co-cited authors, the journals, the co-cited journals, and the keywords co-occurrence network. This robust methodology ensures the reliability and validity of the study’s findings.ResultsA total of 2960 publications, including 2695 articles and 265 reviews, were included in this bibliometric study. There has been no shortage of endophthalmitis-related publications since 1993, with an apparent upward trend during recent years. Possible correlations with the COVID-19 pandemic are also analyzed. These studies were finished by 11,048 authors from 75 countries worldwide, with the United States in the lead. In the keyword co-occurrence network, except for the endophthalmitis term, cataract surgery becomes the keyword with the highest frequency. Different categories of endophthalmitis, including postoperative, post-injection, post-traumatic, and endogenous endophthalmitis, and antibacterial and anti-inflammatory therapies of infectious endophthalmitis, are discussed by categories. From the perspective of the timeline, postoperative and post-injection endophthalmitis were the dominant forms before and after the year 2000, respectively. Co-citation analyses reveal that the Endophthalmitis Vitrectomy Study (EVS) conducted in 1995 provides pivotal guidance for later research. Diverse pathogenic bacteria (e.g., Coagulase-negative Staphylococci, Propionibacterium acnes, Viridians Streptococci, and Bacillus cereus) or fungi (e.g., Candida, Aspergillus, and Fusarium) contribute to varying treatment principles and clinical prognosis, which should be taken seriously. In addition, intravitreal and intracameral antibiotics are the mainstay for treating and preventing infectious endophthalmitis, respectively.ConclusionOur bibliometric analysis provides an overview of dynamic evolution and structural relationships in the research field of endophthalmitis. The displayed hotspots and developmental directions have reference values for future investigation.

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Section: Discussionmentioning

confidence: 99%

Endophthalmitis: a bibliometric study and visualization analysis from 1993 to 2023

Fu,

Du,

Huang

et al. 2024

Front. Cell. Infect. Microbiol.

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“…13 In the present case, the right eye was classified as stage III while the left eye was categorized as stage I. Consequently, a PPV was performed on the right eye, followed by systemic antifungal therapy featuring oral fluconazole administration. For patients with EFE who have not yet developed retinal detachment, that is, patients with EFE before stage IV, it has been reported that intravitreal injection is also an alternative treatment modality, including caspofungin, 14 amphotericin B, 15 and voriconazole. 16 Endogenous fungal endophthalmitis poses a significant threat to ocular health and represents a rare yet serious complication of fungemia.…”

Section: Discussionmentioning

confidence: 99%

Bilateral endogenous Candida albicans endophthalmitis following COVID‐19 infection and intravenous antibiotics use: A case report

Wu,

Wang,

Zhang

2023

Clinical Case Reports

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Key Clinical MessageEndogenous fungal endophthalmitis tends to occur in immunocompromised patients, including COVID‐19 infection. For high‐risk populations, timely tissue biopsy, fungal culture, and susceptibility testing can facilitate early diagnosis and treatment, thereby improving the prognosis.AbstractWhile endogenous fungal endophthalmitis is a rare condition, its incidence has recently been on the rise. A 48‐year‐old male presented with complaints of acute visual loss in his right eye for 2 weeks. He had a history of COVID‐19 infection, confirmed by a positive nucleic acid test, and was treated with intravenous antibiotics and glucocorticoids a week before the episode. A comprehensive eye examination revealed significant inflammatory cells floating in the anterior chamber and considerable cloudiness in the vitreous of the right eye, while few vitreous cells were visualized in the left eye. After pars plana vitrectomy (PPV) was performed in the right eye, a vitreous biopsy revealed an intravitreal infection of Candida albicans, which was susceptible to fluconazole. Endogenous fungal endophthalmitis occurs in patients with various underlying systemic conditions, such as those with diabetes, organ transplantation recipients, individuals undergoing chemotherapy, users of corticosteroids and immunosuppressants, AIDS patients, and those engaged in intravenous drug use. In high‐risk populations associated with intravenous antibiotics, the timely identification of one or more well‐defined oval yellow‐white chorioretinal lesions, especially in the posterior pole of the retina, can contribute to an early diagnosis through tissue biopsy, fungal culture, and susceptibility testing. This approach enables targeted antifungal therapy, thereby improving the prognosis of visual function for the patient.

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“…An intravitreal dose of 50 µg/0.1 ml is safe,[ 18 ] and there are reported successes in multi-antifungal agent-resistant fungal endophthalmitis. [ 19 ] Posaconazole is a triazole compound that disrupts the acyl chains of phospholipids, impairs the functions of certain membrane-bound enzyme systems such as ATPase, and inhibits fungal growth. It is reportedly more potent than the other two azole compounds, voriconazole and itraconazole.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the utility of inflammation score in post-cataract surgery endophthalmitis. Results from a prospective study in India. EMS Report #4

Das,

Belenje,

Joseph

et al. 2023

Indian Journal of Ophthalmology

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Purpose: To investigate if inflammation score (IS), calculated from the cornea, anterior chamber, iris, and vitreous, indicates endophthalmitis severity. Methods: In a prospective study, consecutive adults with a clinical diagnosis of post-cataract endophthalmitis within 6 weeks of surgery were recruited. Patients were allocated to IS-based primary treatment (IS < 10: intravitreal injection and IS ≥ 10: vitrectomy) and randomized to two intravitreal antibiotics combinations (vancomycin + ceftazidime and vancomycin + imipenem). Undiluted vitreous microbiology work-up included culture susceptibility, polymerase chain reaction, Sanger sequencing, and targeted next-generation sequencing. Results: The average age of 175 people was 63.4 ± 10.7 years and included 52.6% small incision cataract surgery and 47.4% phacoemulsification surgery. Severe endophthalmitis (IS ≥ 20), diagnosed in 27.4% of people, had a shorter time to symptoms (average 5.4 vs 8.7 days; P = 0.018), poorer presenting vision (all ≤ hand motion), higher culture positivity (50% vs 30.7%; P = 0.032), and higher Gram-negative bacterial infection (70.8% vs 46.2%; P = 0.042). For IS ≥ 20 discriminant and Gram-negative infection, Spearman’s coefficient was 0.7 [P < 0.0001, 95% confidence interval (CI) 0.59–0.82], with an area under the receiver operating characteristic curve of 0.9 (95% CI 0.85–0.94, P < 0.0001), a Youden index J of 0.74, a sensitivity of 87.2%, and a specificity of 87.5%. The final vision of >20/400 and >20/100 was regained in 50.2% and 29.1% of people, respectively. The susceptibility of common Gram-positive cocci and Gram-negative bacilli was the highest for vancomycin (95.0%) and colistin (88.6%), respectively. NGS detected polymicrobial infection in 88.5% of culture-negative endophthalmitis. Conclusions: Higher inflammation scores indicated severe disease and Gram-negative infection in post-cataract endophthalmitis.

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Endogenous fungal endopthalmitis treated with intravitreal caspofungin in a COVID-19 recovered patient: A case report

Cited by 10 publications

References 9 publications

Endophthalmitis: a bibliometric study and visualization analysis from 1993 to 2023

Endophthalmitis: a bibliometric study and visualization analysis from 1993 to 2023

Bilateral endogenous Candida albicans endophthalmitis following COVID‐19 infection and intravenous antibiotics use: A case report

Evaluating the utility of inflammation score in post-cataract surgery endophthalmitis. Results from a prospective study in India. EMS Report #4

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