PMID- 33775595
OWN - NLM
STAT- MEDLINE
DCOM- 20220404
LR  - 20220531
IS  - 1715-3360 (Electronic)
IS  - 0008-4182 (Linking)
VI  - 57
IP  - 2
DP  - 2022 Apr
TI  - Ocular manifestations of disseminated Mycobacterium chimaera infection after 
      cardiothoracic surgery.
PG  - 90-97
LID - S0008-4182(21)00081-8 [pii]
LID - 10.1016/j.jcjo.2021.02.032 [doi]
AB  - OBJECTIVE: To describe the ocular manifestations of disseminated Mycobacterium 
      chimaera infection after cardiothoracic surgery. DESIGN: Retrospective, 
      observational case series. PARTICIPANTS: Patients with disseminated M. chimaera 
      infection treated at the University of Alberta Hospital and Royal Alexandra 
      Hospital in Edmonton, Alberta, Canada. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
CI  - Copyright (c) 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. 
      All rights reserved.
FAU - Ma, Jingyi
AU  - Ma J
AD  - Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta.
FAU - Ruzicki, Jessica L
AU  - Ruzicki JL
AD  - Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, 
      Alta.
FAU - Carrell, Nathan W
AU  - Carrell NW
AD  - Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, 
      Alta.
FAU - Baker, Chad F
AU  - Baker CF
AD  - Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, 
      Alta.. Electronic address: cfbaker@ualberta.ca.
LA  - eng
PT  - Journal Article
DEP - 20210323
PL  - England
TA  - Can J Ophthalmol
JT  - Canadian journal of ophthalmology. Journal canadien d'ophtalmologie
JID - 0045312
RN  - Mycobacterium chimaera
SB  - IM
MH  - Adult
MH  - Aged
MH  - Alberta
MH  - *Choroid/pathology
MH  - Humans
MH  - Middle Aged
MH  - *Mycobacterium
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2021/03/30 06:00
MHDA- 2022/04/05 06:00
CRDT- 2021/03/29 05:50
PHST- 2021/01/18 00:00 [received]
PHST- 2021/02/16 00:00 [revised]
PHST- 2021/02/18 00:00 [accepted]
PHST- 2021/03/30 06:00 [pubmed]
PHST- 2022/04/05 06:00 [medline]
PHST- 2021/03/29 05:50 [entrez]
AID - S0008-4182(21)00081-8 [pii]
AID - 10.1016/j.jcjo.2021.02.032 [doi]
PST - ppublish
SO  - Can J Ophthalmol. 2022 Apr;57(2):90-97. doi: 10.1016/j.jcjo.2021.02.032. Epub 
      2021 Mar 23.