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February 1974

Candida Endophthalmitis Associated With Intravenous Hyperalimentation

Author Affiliations

Iowa City; Montreal
From the departments of surgery and ophthalmology, Royal Victoria Hospital and McGill University, Montreal. Dr. Freeman is now with University Hospitals, University of Iowa, Iowa City.

Arch Surg. 1974;108(2):237-240. doi:10.1001/archsurg.1974.01350260089022

Prolonged venous catheterization and intravenous administration of alimentation in malnourished patients is associated with an increased risk of systemic candidiasis, and the eye is not immune to invasion by this organism. Endophthalmitis is a serious complication with a high incidence of visual loss and mortality. It is difficult to diagnose, and it may be present when Candida organisms have not been grown from any other sites. The presence of eye pain or other visual disturbances combined with the rather characteristic funduscopic appearance of "cotton wool" exudates are absolute indications for the prompt administration of amphotericin B. Routine ophthalmoscopy is an important part of the daily management of any patient in whom the physician has reason to suspect fungal overgrowth.