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Ocular and Orbital Infections in the Immunocompromised Cancer Patient

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Ophthalmic Oncology

Part of the book series: M.D. Anderson Solid Tumor Oncology Series ((MDA,volume 6))

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Abstract

Significant progress has been made in the treatment of cancer patients, and the proportion of cancer patients achieving complete remission and longer survival has increased in recent years. However, a significant proportion of patients still do not achieve complete remission, and infection remains a frequent cause of treatment failure, particularly in patients with hematologic malignancies. Ocular and orbital infections are particularly important, not only because of their frequency but also because of the associated local and systemic morbidity. Opportunistic infections can be found in all areas in and around the eye: in extraocular locations (neuro-ophthalmic, orbital, ocular adnexa), in the anterior segment (cornea and conjunctiva), and in the posterior segment (retina and choroid). All opportunistic infections of the eye have their origin in suppression of the host’s immune system. Immune suppression can be acquired as a result of immunosuppressive therapy in solid organ transplant recipients or chemotherapy in patients with myeloproliferative disorders or solid tumors. Neutropenia remains the most important factor predisposing patients to infections.

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References

  1. Marchetti O, Calandra T. Infections in the neutropenic cancer patient. In: Cohen J, Powderly WG, editors. Infectious Diseases, second edition. New York, NY: Mosby, 2004:1077–93.

    Google Scholar 

  2. Segal BH, Walsh TJ, Gea-Banacloche J, et al. Infections in the cancer patient. In: DeVita VT Jr, Hellman S, Rosenberg SA, editors. Cancer Principles and Practice of Oncology, seventh edition. Philadelphia, PA: Lippincott Williams & Wilkins, 2005:2461–2511.

    Google Scholar 

  3. Bannister B, Gillespie S, Jones J. Infections in immunocompromised patients. In: Infection Microbiology and Management. Oxford: Blackwell, 2006:431–42.

    Google Scholar 

  4. Rolston KV. Infection in the neutropenic patient. In: Kantarjuan HM, Wolff RA, Koller CA, editors. The M. D. Anderson Manual of Medical Oncology. New York, NY: McGraw-Hill, 2006:957–66.

    Google Scholar 

  5. Vento S, Cainelli F. Infections in patients with cancer undergoing chemotherapy: aetiology, prevention, and treatment. Lancet 2003;4:595–604.

    Article  Google Scholar 

  6. Easty DL. Infection in the compromised eye. Trans Am Ophthalmol Soc 1986;105:61–8.

    Google Scholar 

  7. Bal AM, Gould IM. Empirical antimicrobial treatment for chemotherapy-induced febrile neutropenia. Int J Antimicrob Agents 2007;29:501–9.

    Article  PubMed  CAS  Google Scholar 

  8. Oken MM, Pomeroy C, Weisdorf D, et al. Prophylactic antibiotics for the prevention of early infection in multiple myeloma. Am J Med 1996;100:624–8.

    Article  PubMed  CAS  Google Scholar 

  9. Noskin GA. Prevention of infection in immunocompromised hosts. In: Management of Infectious Complications in Cancer Patients. Boston: Kluwer, 1998:223–46.

    Google Scholar 

  10. Kowalski RP, Karenchak LM, Romanowski EG. Infectious disease: changing antibiotic susceptibility. Ophthalmol Clin North Am 2004;16:1–9.

    Article  Google Scholar 

  11. Bodey GP, Chamaly RF, Kontoyiannis DP. Fungal and viral infections in cancer patients. In: Kantarjuan HM, Wolff RA, Koller CA, editors. The M. D. Anderson Manual of Medical Oncology. New York, NY: McGraw-Hill, 2006:967–92.

    Google Scholar 

  12. Samonis G, Bafaloukos D. Fungal infections in cancer patients: an escalating problem. In Vivo 1992;6:183–94.

    PubMed  CAS  Google Scholar 

  13. Powles RL. Systemic fungal infections: major problems in cancer patients. Indian J Cancer 1994;31:180–4.

    PubMed  CAS  Google Scholar 

  14. Mays SR, Bogle MA, Bodey GP. Cutaneous fungal infections in the oncology patient. Am J Clin Dermatol 2006;7:31–43.

    Article  PubMed  Google Scholar 

  15. Cornely OA, Bohme A, Reichert D, et al. Risk factors for breakthrough invasive fungal infection during secondary prophylaxis. J Antimicrob Chemother 2008;61:939–46.

    Article  PubMed  CAS  Google Scholar 

  16. Anaissie E. Opportunistic mycoses in the immunocompromised host: experience at a cancer center and review. Clin Infect Dis 1992;14:S43–53.

    Article  PubMed  Google Scholar 

  17. Herbrecht R, Denning DW, Patterson TF. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002;347:408–15.

    Article  PubMed  CAS  Google Scholar 

  18. Rolston KV, Bodey GP, Safdar A. Polymicrobial infection in patients with cancer: an underappreciated and underreported entity. Clin Infect Dis 2007;45:228–33.

    Article  PubMed  Google Scholar 

  19. Jack MK, Hicks JD. Ocular complications in high-dose chemoradiotherapy and marrow transplantation. Ann Ophthalmol 1981;13:709–11.

    PubMed  CAS  Google Scholar 

  20. Lynn WA, Lightman S. The eye in systemic infection. Lancet 2004;364:1439–50.

    Article  PubMed  CAS  Google Scholar 

  21. Khan A, Okhravi N, Lightman S. The eye in systemic sepsis. Clin Med 2002;2:444–8.

    PubMed  Google Scholar 

  22. Mahajan VM. Acute bacterial infections of the eye: their aetiology and treatment. Br J Ophthalmol 1983;67:191–4.

    Article  PubMed  CAS  Google Scholar 

  23. Guembel HOC, Ohrloff C. Opportunistic infections of the eye in immunocompromised patients. Ophthalmologica 1997;211:53–61.

    Article  PubMed  Google Scholar 

  24. Bialasiewicz AA, Knospe V, Richard G. Ocular infections in the immunocompromised host. Dev Ophthalmol 1999;30:203–19.

    Article  Google Scholar 

  25. Sridhar MS, Laibson PR, Rapuano CJ, et al. Infectious crystalline keratopathy in an immunosuppressed patient. CLAO J 2001;27:108–10.

    PubMed  CAS  Google Scholar 

  26. Jain ML, Garg AK. Metastatic endophthalmitis in a patient with major burns: a rare complication. Burns 1995;21:72–3.

    Article  PubMed  CAS  Google Scholar 

  27. Tabbara KF, Juffali F, Matossian RM. Bacillus laterosporus endophthalmitis. Arch Ophthalmol 1977;95:2187–9.

    Article  Google Scholar 

  28. Hornblass A, To K, Coden DJ, et al. Endogenous orbital cellulites and endogenous endophthalmitis in subacute bacterial endocarditis. Am J Ophthalmol 1989;108:196–7.

    PubMed  CAS  Google Scholar 

  29. Li S, Perlman JI, Edward DP, et al. Unilateral blastomyces dermatitidis endophthalmitis and orbital cellulites. Ophthalmology 1998;105:1466–70.

    Article  PubMed  CAS  Google Scholar 

  30. Maccheron LJ, Groeneveld ER, Ohlrich SJ, et al. Orbital cellulitis, panophthalmitis, and ecthyma gangrenosum in an immunocompromised host with Pseudomonas septicemia. Am J Ophthalmol 2004;137;176–8.

    Article  PubMed  Google Scholar 

  31. Lakosha H, Pavlin CJ, Lipton J. Subretinal abscess due to Nocardia farcinica infection. Retina 2000;20:269–74.

    Article  PubMed  CAS  Google Scholar 

  32. Tsai PS, DeAngelis DD, Spencer WH, et al. Bacillary angiomatosis of the anterior orbit, eyelid, and conjunctiva. Am J Ophthalmol 2002;134:433–4.

    Article  PubMed  Google Scholar 

  33. Patel SJ, Petrarca R, Shah SM, et al. Atypical bartonella henselae chorioretinitis in an immunocompromised patient. Ocul Immunol Inflamm 2008;16:45–9.

    Article  PubMed  Google Scholar 

  34. Koreishi AF, Schechter BA, Karp CL. Ocular infections caused by Providencia rettgeri. Ophthalmology 2006;113:1463–6.

    Article  PubMed  Google Scholar 

  35. Hoerni B, Vallat M, Durand M, et al. Ocular toxoplasmosis and Hodgkin’s disease. Arch Ophthalmol 1978;96:62–3.

    Article  PubMed  CAS  Google Scholar 

  36. Shah MK, Sebti A, Kiehn TE, et al. Mycobacterium haemophilum in immunocompromised patients. Clin Infect Dis 2001;33:330–7.

    Article  PubMed  CAS  Google Scholar 

  37. Millar MJ, Bulliard C, Balachandran C, et al. Mycobacterium haemophilum infection presenting as filamentary keratopathy in an immunocompromised adult. Cornea 2007;26:764–6.

    Article  PubMed  Google Scholar 

  38. Modi D, Pyatetsky D, Edward DP, et al. Mycobacterium haemophilum, a rare cause of endophthalmitis. Retina 2007;27:1148–51.

    Article  PubMed  Google Scholar 

  39. Ali S, Sivak-Callcot JA, Khakoo R, et al. Mycobacterium fortuitum infection masquerading as an orbital mass. Ophthal Plast Reconstr Surg 2007;23:327–9.

    Article  PubMed  Google Scholar 

  40. Bansal R, Tutrone WD, Weinberg JM. Viral skin infections in the elderly. Drugs Aging 2002;19:503–14.

    Article  PubMed  Google Scholar 

  41. Khan BF, Pavan-Langston D. Clinical manifestations and treatment modalities in herpes simplex virus of the ocular anterior segment. Int Ophthalmol Clin 2004;44:103–33.

    Article  PubMed  Google Scholar 

  42. Foster WJ, Krause MD, Custer PL. Herpes simplex virus dacryoadenitis in an immunocompromised patient. Arch Ophthalmol 2003;121:911–12.

    Article  PubMed  Google Scholar 

  43. Lightman S, Marsh RJ, Powell D. Herpes zoster ophthalmicus: a medical review. Br J Ophthalmol 1981;65:539–41.

    Article  PubMed  CAS  Google Scholar 

  44. Greven CM, Singh T, Stanton CA, et al. Optic chiasm, optic nerve, and retinal involvement secondary to varicella-zoster virus. Arch Ophthalmol 2001;119:608–10.

    Article  PubMed  CAS  Google Scholar 

  45. Friedlander SM, Rahhal FM, Ericson L, et al. Optic neuropathy preceding acute retinal necrosis in acquired immunodeficiency syndrome. Arch Ophthalmol 1995;114:1481–5.

    Article  Google Scholar 

  46. Lee MS, Cooney EL, Stoessol KM, et al. Varicella zoster virus retrobulbar optic neuritis proceeding retinitis in patients with acquired immune deficiency syndrome. Ophthalmology 1998;105:467–71.

    Article  PubMed  CAS  Google Scholar 

  47. Long HM, Dick A. Presumed CMV associated necrotizing retinopathy in a non-HIV immunocompromised host. Clin Exp Ophthalmol 2005;33:330–5.

    Article  Google Scholar 

  48. Foster RE, Peterson MR, Neuss MN, et al. Progressive outer retinal necrosis syndrome in a lymphoma patient with good visual outcome. Am J Ophthalmol 2001;132:117–20.

    Article  PubMed  CAS  Google Scholar 

  49. Kalpoe JS, van Dehn CE, Bollemeijer JG, et al. Varicella zoster virus (VZV)-related progressive outer retinal necrosis (PORN) after allogeneic stem cell transplantation. Bone Marrow Transplant 2005;36:467–9.

    Article  PubMed  CAS  Google Scholar 

  50. Westeneng AC, Rothova A, De Boer JH, et al. Infectious uveitis in immunocompromised patients and the diagnostic value of polymerase chain reaction and Goldmann-Witmer coefficient in aqueous analysis. Am J Ophthalmol 2007;144:781–5.

    Article  PubMed  Google Scholar 

  51. Akpek EK, Kent C, Jakobiec F, et al. Bilateral acute retinal necrosis caused by cytomegalovirus in an immunocompromised patient. Am J Ophthalmol 1999;127:93–5.

    Article  PubMed  CAS  Google Scholar 

  52. Derzko-Dzulynsky LA, Berger AR, Berinstein NL. Cytomegalovirus retinitis and low-grade non-Hodgkin’s lymphoma: case report and review of the literature. Am J Hematol 1998;57:228–32.

    Article  PubMed  CAS  Google Scholar 

  53. Duker JS, Blumenkranz MS. Diagnosis and management of the acute retinal necrosis syndrome (ARN). Surv Ophthalmol 1995;35:327–43.

    Article  Google Scholar 

  54. Pollard RB, Egbert PR, Gallagher JG, et al. Cytomegalovirus retinitis in immunosuppressed hosts. I. Natural history and effects of treatment with adenine arabinoside. Ann Intern Med 1980;93:655–64.

    PubMed  CAS  Google Scholar 

  55. Egbert PR, Pollard RB, Gallagher JG, et al. Cytomegalovirus retinitis in immunosuppressed hosts. II. Ocular manifestation. Ann Intern Med 1980;93:664–70.

    PubMed  CAS  Google Scholar 

  56. Segal BH, Almyroudis NG, Battiwalla M, et al. Prevention and early treatment of invasive fungal infection in patients with cancer and neutropenia and stem cell transplant recipients in the era of newer broad-spectrum antifungal agents and diagnostic adjuncts. Clin Infect Dis 2007;44:402–9.

    Article  PubMed  Google Scholar 

  57. Thursky KA, Playford EG, Seymour JF, et al. Recommendations for the treatment of established fungal infections. Intern Med J 2008;38:496–520.

    Article  PubMed  CAS  Google Scholar 

  58. Hariprasad SM, Mieler WF, Lin TK, et al. Voriconazole in the treatment of fungal eye infections: a review of current literature. Br J Ophthalmol 2008;92:871–8.

    Article  PubMed  CAS  Google Scholar 

  59. de O Machado O, Goncalves R, Fernandes EM, et al. Bilateral aspergillus endophthalmitis in a patient with chronic lymphocytic leukaemia. Br J Ophthalmol 2003;87:1429–30.

    Article  Google Scholar 

  60. Hilal AA, Taj-Aldeen SJ, Mirghani AH. Rhinoorbital mucormycosis secondary to Rhizopus oryzae: a case report and literature review. Ear Nose Throat J 2004;83:556–62.

    PubMed  Google Scholar 

  61. Jeevanan J, Gendeh BS, Faridah HA, et al. Rhino-orbito-cerebral mucormycosis: a treatment dilemma. Med J Malaysia 2006;61:106–8.

    PubMed  CAS  Google Scholar 

  62. Louie T, el Baba F, Shulman M, et al. Endogenous endophthalmitis due to fusarium: case report and review. Clin Infect Dis 1994;18:585–8.

    Article  PubMed  CAS  Google Scholar 

  63. O’Doherty M, Hannan M, Fulcher T. Voriconazole in the treatment of fungal osteomyelitis of the orbit in the immunocompromised host. Orbit 2005;24:285–9.

    Article  PubMed  Google Scholar 

  64. Wood GM, McCormack JG, Muir DB, et al. Clinical features of human infection with Scedosporium inflatum. Clin Infect Dis 1992;14:1027–33.

    Article  PubMed  CAS  Google Scholar 

  65. Gluckman SJ, Ries K, Abrutyn E. Allescheria (Petriellidium) boydii sinusitis in a compromised host. J Clin Microbiol 1977;5:481–4.

    PubMed  CAS  Google Scholar 

  66. Anderson RL, Carroll TF, Harvey JT. Petriellidium (Allescheria) boydii orbital and brain abscess treated with intravenous miconazole. Am J Ophthalmol 1984;97:771–5.

    PubMed  CAS  Google Scholar 

  67. Jones J, Katz SE, Lubow M. Scedosporium apiospermum of the orbit. Arch Ophthalmol 1999;117:27203.

    Google Scholar 

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Authors and Affiliations

  1. Danville San Ramon Eye Medical Corp., Danville, CA, USA

    Viet H. Ho

  2. Jefferson Medical College, Philadelphia, PA, USA

    Hao H. Ho

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  1. Viet H. Ho
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  2. Hao H. Ho
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Correspondence to Viet H. Ho .

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  1. M.D. Anderson Cancer Center, Section of Ophthalmology, The University of Texas, Houston, 77030, Texas, USA

    Bita Esmaeli

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Ho, V.H., Ho, H.H. (2010). Ocular and Orbital Infections in the Immunocompromised Cancer Patient. In: Esmaeli, B. (eds) Ophthalmic Oncology. M.D. Anderson Solid Tumor Oncology Series, vol 6. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-0374-7_28

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  • DOI: https://doi.org/10.1007/978-1-4419-0374-7_28

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