September 26, 1994

Mortality of Hospitalized Patients With Candida Endophthalmitis

Author Affiliations

From the Departments of Ophthalmology (Drs Menezes, Sigesmund, and Devenyi) and Anaesthesia and Surgery (Dr Demajo), The Toronto (Ontario) Hospital.

Arch Intern Med. 1994;154(18):2093-2097. doi:10.1001/archinte.1994.00420180103012

Background:  Candida is becoming an important nosocomial pathogen as the incidence of hospital-acquired candidemia is rising. Candida endophthalmitis is a good indicator of systemic candidiasis in hospitalized patients.

Methods:  Thirteen (17%) of 76 ophthalmologic consultations for Candida endophthalmitis in our institution had positive findings during a 12-month period. We studied these 13 patients with Candida endophthalmitis to evaluate their outcomes.

Results:  All 13 patients were admitted to a large tertiary care hospital, and 10 (77%) were in an intensive care unit. The overall mortality was 77% for all patients and 80% for the intensive care patients. This mortality was higher than the overall mortality for all patients in the surgical intensive care unit in our institution (17%), as well as the mortality for our patients with candidemia in the surgical intensive care unit (61%).

Conclusions:  The strikingly high mortality in our group of patients with Candida endophthalmitis reflects the fact that they are a seriously ill group with multiple risk factors for Candida infection. This information suggests that the presence of Candida endophthalmitis is a good indicator of high mortality in seriously ill patients in intensive care units.(Arch Intern Med. 1994;154:2093-2097)