Ocular manifestations of disseminated Mycobacterium chimaera infection after cardiothoracic surgery. 2022

Jingyi Ma, and Jessica L Ruzicki, and Nathan W Carrell, and Chad F Baker
Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta.

To describe the ocular manifestations of disseminated Mycobacterium chimaera infection after cardiothoracic surgery. Retrospective, observational case series. Patients with disseminated M. chimaera infection treated at the University of Alberta Hospital and Royal Alexandra Hospital in Edmonton, Alberta, Canada. Seven patients (14 eyes) with systemic M. chimaera infection after aortic graft and/or valvular surgeries were reviewed for ocular involvement. Cases were identified based on histopathologic analysis of cardiac tissue, repeat positive mycobacterial blood cultures, and cerebrospinal fluid analysis. Clinical ocular findings, fundus autofluorescence, fluorescein angiography, spectral-domain optical coherence tomography (SD-OCT), and autopsy results are described. The mean age of our patients was 63 years (range, 22-76 years). Aortic graft and/or valvular surgeries were performed between June 2015 and April 2016. The mean duration from surgery to diagnosis of infection was 27 months (range, 19-36 months). All patients exhibited white-yellowish choroidal lesions. Bilateral, multifocal choroiditis was observed in 6 patients (12 eyes), who died of disseminated M. chimaera infection despite aggressive, multiagent antimicrobial therapy. One patient had a solitary, white-yellow choroidal lesion in the left eye only. Choroidal lesions were hyperfluorescent on late-phase fluorescein angiography and corresponded to localized choroidal thickening and retinal elevation on SD-OCT. M. chimaera infection after cardiothoracic surgery can cause life-threatening disease involving multiple organ systems. Ocular involvement is an important and possibly early clinical finding, with good correlation to systemic disease severity. Ophthalmological assessment and multimodal imaging may aid in early diagnosis and can be used to monitor disease progression.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009161 Mycobacterium A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. Mycobacteria
D002829 Choroid The thin, highly vascular membrane covering most of the posterior of the eye between the RETINA and SCLERA. Choriocapillaris,Haller Layer,Haller's Layer,Sattler Layer,Sattler's Layer,Choroids
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000416 Alberta A province of western Canada, lying between the provinces of British Columbia and Saskatchewan. Its capital is Edmonton. It was named in honor of Princess Louise Caroline Alberta, the fourth daughter of Queen Victoria. (From Webster's New Geographical Dictionary, 1988, p26 & Room, Brewer's Dictionary of Names, 1992, p12)
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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