Endogenous mycotic endophthalmitis: Variations in clinical and histopathologic changes in candidiasis compared with aspergillosis
Endogenous mycotic endophthalmitis: Variations in clinical and histopathologic changes in candidiasis compared with aspergillosis
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DOI：
10.1016/s0002-9394(01)00968-0
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发表时间：
2001-08-01
影响因子：
4.2
通讯作者：
Hidayat, AA
中科院分区：
文献类型：
--
作者：
Rao, NA;Hidayat, AA
目得：描述的临床和/或组织病理学特征，可以帮助区分内源性念珠菌眼内炎内源性曲霉菌眼内炎症和眼内传播这些agents.METHODS：25例进行眼球摘除术，13例形态学特征和/或阳性培养曲霉菌和12例组织学证据和/或阳性培养念珠菌被列入研究。从每个病例中获取临床信息。艾滋病患者被排除。分析去核球体以检测真菌的位置、这些试剂的血管侵袭和炎症反应。0结果：念珠菌性眼内炎见于有胃肠道手术、高营养或糖尿病史的患者，而曲霉病见于接受过器官移植或心脏手术的患者。组织学上，玻璃体是念珠菌感染的主要病灶，而视网膜下/视网膜下色素上皮感染见于曲霉菌病。曲霉菌病患者视网膜和脉络膜血管壁受真菌成分侵袭，而念珠菌病患者则无此表现。两种感染因子均诱导化脓性非肉芽肿性炎症。0结论：与念珠菌性眼内炎不同。pergillosis临床上表现为广泛区域的深层视网膜炎/脉络膜炎，玻璃体活检可能不会产生阳性结果。组织学上，曲霉菌似乎优先沿着视网膜下色素上皮和视网膜下间隙生长。这种眼内感染通常与脑和心脏并发症引起的高死亡率相关。(C)2001年，Elsevier Science Inc. All rights reserved.
PURPOSE: To describe clinical and/or histopathologic features that could help distinguish endogenous Candida endophthalmitis from endogenous Aspergillus intraocular inflammation and to provide histologic documentation of intraocular spread of these agents.METHODS: Twenty-five patients who underwent enucleation, 13 with morphologic features and/or positive culture for Aspergillus and 12 with histologic evidence and/or positive culture for Candida were included in the study. Clinical information was sought from each case. Patients with AIDS were excluded. The enucleated globes were analyzed to detect location of the fungi, vascular invasion by these agents, and inflammatory response. 0RESULTS: Candida endophthalmitis was noted in patients with a history of gastrointestinal surgery, hyperalimentation, or diabetes mellitus, whereas aspergillosis was present in patients who had undergone organ transplantation or cardiac surgery. Histopathologically, the vitreous was the primary focus of infection for Candida, whereas subretinal/subretinal pigment epithelium infection was noted in eyes with aspergillosis. Retinal and choroidal vessel wall invasion by fungal elements was noted in cases of aspergillosis but not in cases with candidiasis. Both infectious agents induced suppurative nongranulomatous inflammation. 0CONCLUSIONS: Unlike Candida endophthalmitis, as. pergillosis clinically presents with extensive areas of deep retinitis/choroiditis, and vitreous biopsy may not yield positive results. Histopathologically, it appears that Aspergillus grows preferentially along subretinal pigment epithelium and subretinal space. This intraocular infection is usually associated with a high rate of mortality caused by cerebral and cardiac complications. (C) 2001 by Elsevier Science Inc. All rights reserved.