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Mycotic keratitis

Sergio Sara, Kendall Sharpe, Sharon Morris
Mycotic keratitis is an ocular infective process derived from any fungal species capable of corneal invasion. Despite its rarity in developed countries, its challenging and elusive diagnosis may result in keratoplasty or enucleation following failed medical management. Filamentous fungi such as Fusarium are often implicated in mycotic keratitis. Bearing greater morbidity than its bacterial counterpart, mycotic keratitis requires early clinical suspicion and initiation of antifungal therapy to prevent devastating consequences...
August 3, 2016: BMJ Case Reports
E M Messmer
Histopathological evaluation of ocular tissues is important in differentiating between infectious and autoimmune disease. Inflammation, necrosis and keratolysis are common to most forms of keratitis. Histopathology can be of great help in identifying the causative organism, establishing a final diagnosis and/or managing the patient with herpes simplex virus keratitis, mycotic keratitis, acanthamoeba keratitis or microsporidia keratoconjunctivitis. Important pathogenetic knowledge with therapeutic relevance has been gained from histopathological studies in nummular keratitis after epidemic keratoconjunctivitis and atopic keratoconjunctivitis...
July 2016: Klinische Monatsblätter Für Augenheilkunde
Prafulla K Maharana, Namrata Sharma, Ritu Nagpal, Vishal Jhanji, Sujata Das, Rasik B Vajpayee
Mycotic keratitis is a major cause of corneal blindness, especially in tropical and subtropical countries. The prognosis is markedly worse compared to bacterial keratitis. Delayed diagnosis and scarcity of effective antifungal agents are the major factors for poor outcome. Over the last decade, considerable progress has been made to rapidly diagnose cases with mycotic keratitis and increase the efficacy of treatment. This review article discusses the recent advances in diagnosis and management of mycotic keratitis with a brief discussion on rare and emerging organisms...
May 2016: Indian Journal of Ophthalmology
Catherine Q Sun, N Venkatesh Prajna, Tiruvengada Krishnan, Revathi Rajaraman, Muthiah Srinivasan, Anita Raghavan, Kieran S O'Brien, Stephen D McLeod, Nisha R Acharya, Jennifer Rose-Nussbaumer
BACKGROUND: To determine if pretreatment with antifungal agents is predictive of worse clinical outcome in a fungal keratitis clinical trial. DESIGN: Non-pre-specified subgroup analysis of a randomized controlled trial in a tertiary hospital. PARTICIPANTS: 323 fungal ulcer cases with enrollment visual acuity of 20/40 to 20/400. METHODS: The Mycotic Ulcer Treatment Trial I was a randomized, double-masked trial to determine the optimal treatment for filamentous fungal keratitis at the Aravind Eye Care System, India...
June 21, 2016: Clinical & Experimental Ophthalmology
Yashik Bansal, Jagdish Chander, Neelam Kaistha, Nidhi Singla, Sunandan Sood, Anne D van Diepeningen
The two most common filamentous fungi causing mycotic keratitis are Aspergillus and Fusarium spp. Around 70 Fusarium spp. are involved in causing human infections. In this study, four cases of keratitis in sugarcane farmers in India are being reported, caused by the sugar cane pathogen Fusarium sacchari, a species of the Fusarium fujikuroi species complex. Fusarial keratitis was established by potassium hydroxide/Calcofluor white wet mounts and fungal culture of corneal scrapings on conventional media. Final identification was done by genetic sequencing at CBS-KNAW, Utrecht, The Netherlands...
June 13, 2016: Mycoses
Prashant Garg, Aravind Roy, Sanhita Roy
PURPOSE OF REVIEW: The aim of this review article is to present an overview of some of the seminal work published in the last 18 months (July 2014 to December 2015). RECENT FINDINGS: The published literature highlights the need for the identification of fungal isolates to species and subspecies level using molecular methods. Molecular methods helped us identify some of the unknown fungi such as Pythium - fungi that causes keratitis unresponsive to conventional antifungal therapy...
July 2016: Current Opinion in Ophthalmology
Mohammad M Khater
AIM: To compare augmented therapy with argon laser and amniotic membrane graft (AMG) versus AMG and tissue debridement for resistant mycotic corneal ulcers. METHODS: This study included 40 cases of resistant fungal corneal ulcers in two groups. In one group, argon laser photocoagulation and AMG were done while AMG with tissue debridement was done as adjunctive therapy for the specific antifungal agents. RESULTS: Complete healing with no adverse effects was achieved in argon laser group in duration ranging from 2-3 weeks in all cases...
April 14, 2016: Seminars in Ophthalmology
Luxia Wang, Abdullah M S Al-Hatmi, Xuwen Lai, Lianghong Peng, Chuanhong Yang, Huangwen Lai, Jianxun Li, Jacques F Meis, G Sybren de Hoog, Chao Zhuo, Min Chen
We report a case of mycotic keratitis caused by Bipolaris oryzae with predisposing trauma from a foreign body. The fungus was identified by sequencing the internal transcribed spacer region, translation elongation factor 1α (TEF1) gene, and partial glyceraldehyde-3-phosphate dehydrogenase (GPDH) gene, and the species identity was confirmed on the basis of its characteristic conidial phenotype. The patient was treated with surgical intervention and antifungal agents, including intravenous fluconazole (FLC), oral itraconazole, topical 0...
May 2016: Diagnostic Microbiology and Infectious Disease
Mohammad M Khater, Mohammad S El-Shorbagy, Adel A Selima
AIM: To compare argon laser photocoagulation and intrastromal injection of voriconazole as adjunctive treatment modalities in cases of resistant mycotic corneal ulcers. METHODS: Two groups each of them included 20 cases of resistant mycotic corneal ulcers. Both groups treated with local and systemic specific antimicrobial drugs guided with culture and sensitivity results. In one group argon laser photocoagulation was used as an adjunctive therapy to the specific antifungal drugs and in the other group, intrastromal injection of voriconazole was done besides the specific antifungal drugs...
2016: International Journal of Ophthalmology
Mirosław Słowik, Monika M Biernat, Donata Urbaniak-Kujda, Katarzyna Kapelko-Słowik, Marta Misiuk-Hojło
Fungal infections of the eye are an important cause of significant visual loss and blindness in some regions of the world, especially developing countries. Ocular mycoses remain a diagnostic and therapeutic challenge to the ophthalmologist. Corneal infection is the most frequent presentation, but the orbit, eyelids, lacrimal apparatus, conjunctiva, sclera and internal structures of the eye can also be affected. Candida spp., Fusarium spp. and Aspergillus spp. are the most frequently isolated organisms in fungal keratitis and in endophthalmitis...
November 2015: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Hind M Alkatan, Azza Maktabi, Mosa Al-Harby, Ali A Al-Rajhi
Fungal keratitis accounts for 6-53% of all cases of ulcerative keratitis in variable studies. The majority of cases are due to septate fungi. The abnormal cornea in cases of dry eye syndrome, chronic ulceration, erythema multiform and possibly HIV infection is infected more commonly with Candida, most commonly Candida albicans. Candida parapsilosis affects neonates and intensive care unit (ICU) patients and it has been recently found with increasing frequency. In a previous study on mycotic keratitis in our tertiary eye hospital, filamentous fungi were more commonly isolated than yeasts...
October 2015: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Jennifer Rose-Nussbaumer, N Venkatesh Prajna, Tiruvengada Krishnan, Jeena Mascarenhas, Revathi Rajaraman, Muthiah Srinivasan, Anita Raghavan, Catherine E Oldenburg, Kieran S O'Brien, Kathryn J Ray, Travis C Porco, Stephen D McLeod, Nisha R Acharya, Jeremy D Keenan, Thomas M Lietman
BACKGROUND/AIMS: The Mycotic Ulcer Treatment Trial I (MUTT I) was a double-masked, multicentre, randomised controlled trial, which found that topical natamycin is superior to voriconazole for the treatment of filamentous fungal corneal ulcers. In this study, we determine risk factors for low vision-related quality of life in patients with fungal keratitis. METHODS: The Indian visual function questionnaire (IND-VFQ) was administered to MUTT I study participants at 3 months...
November 3, 2015: British Journal of Ophthalmology
Ramu Muthu Selvam, Rathnavel Nithya, Palraj Narmatha Devi, R S Bhuvana Shree, Murugesan Valar Nila, Naveen Luke Demonte, Chitra Thangavel, Jayapal Jeya Maheshwari, Prajna Lalitha, Namperumalsamy Venkatesh Prajna, Kuppamuthu Dharmalingam
Aspergillus flavus is one of the predominant causative organisms of mycotic keratitis in tropical parts of the world. Extracellular proteins are the earliest proteins that come in contact with the host and have a role in the infection process. Exoproteins of A. flavus isolated from infected cornea, sputum and a saprophyte were pooled and identified using high resolution mass spectrometry in order to get the total exoproteome from cultures isolated from different sources. A total of 637 proteins was identified from the pooled A...
March 2015: Data in Brief
Bhavana Sharma, Preeti Kataria, Reena Anand, Rachna Gupta, Kavita Kumar, Salil Kumar, Richa Gupta
PURPOSE: The objectives of this study were to assess visual and structural outcomes in mycotic keratitis after conventional treatment (topical and systemic antifungals) and intracameral amphotericin B (ICAMB), and to evaluate any complications. DESIGN: This was a prospective, nonrandomized, nonblinded interventional study. METHODS: This study was conducted on 104 eyes of 104 patients with fungal corneal ulcers. Patients were categorized into 2 groups: group A, who received conventional topical and systemic antifungal medications, and group B, who received ICAMB in the dose of 5 to 10 μg in 1 mL of 5% dextrose...
November 2015: Asia-Pacific Journal of Ophthalmology
W Behrens-Baumann, D Finis, C MacKenzie, M Roth, G Geerling
Mycotic keratitis is a comparatively rare but serious ophthalmological disease, that can possibly lead to a severe loss of vision up to blindness. Over the last two decades an increase of cases with mycotic keratitis has been noticed, which is possibly caused by an increased use of soft contact lenses. This article gives an overview of the typical clinical signs and symptoms of keratomycosis, tried and tested diagnostics and therapy as well as new diagnostic and therapeutic developments and findings.
June 2015: Klinische Monatsblätter Für Augenheilkunde
Manikandan Palanisamy, Narendran Venkatapathy, Vijayakumar Rajendran, Coimbatore Subramanian Shobana
Graphium eumorphum is rarely associated with mycotic keratitis. We report the case of a 30-year-old female presented with complaints of redness and defective vision in the left eye for one month. Gram staining and 10% KOH wet mount of corneal smears revealed fungal filaments. On potato dextrose agar, fast growing greyish white colonies turning grayish black on maturity was obtained. Lactophenol cotton blue (LPCB) staining confirmed the isolate as Graphium eumorphum. The infection was resolved with the combination of natamycin, econazole and itraconazole...
April 2015: Journal of Clinical and Diagnostic Research: JCDR
Nicolás Refojo, Patricia Minervini, Alejandra I Hevia, Ruben A Abrantes, Julián Fernández, Norma Apestey, Mariana Garnero, Margarita Villada, Graciela Davel
BACKGROUND: Mycotic keratitis by moulds (MKM) is an important cause for corneal blindness and usually carries an unfavorable prognosis. AIMS: This study describes the risk factors and demographic and microbiological features of all MKM cases in Santa Lucía Ophthalmology Hospital during a period of 6 years. METHODS: A prospective study was performed for all MKM cases diagnosed between October 2007 and September 2013. RESULTS: Among 157 diagnosed cases, direct microscopic examination and culture were positive in 97 and 96% of the cases respectively...
January 2016: Revista Iberoamericana de Micología
Anindita Mondal, Udayaditya Mukhopadhyay, Anup Mondal, Ujjwal Pattanayak, Suman Mukhopadhyay, Sambuddha Ghosh, Nazarul Islam
Microbial keratitis tops the list of the diseases leading to corneal blindness. Corneal transplant, either partial or full thickness, is the most helpful technique for infective keratitis that remains non- responsive, even with the most suitable medical treatment. Aims of this study are to evaluate the success of therapeutic penetrating keratoplasty in non-responsive microbial keratitis in eradication of infection, restoration of anatomical integrity of the globe and prevention of complication that influence the visual prognosis in a positive way...
January 2014: Journal of the Indian Medical Association
Matthew Zhang, James Chelnis, Louise A Mawn
Necrotizing fasciitis is most often caused by either polymicrobial bacterial infections or by Gram-positive organisms, such as Streptococcus or Staphylococcus; however, rare cases of fungal necrotizing fasciitis have been reported. Candida parapsilosis is an emerging fungal pathogen. This fungus grows in either a yeast or pseudohyphal form. C. parapsilosis has been reported to cause keratitis, intraocular infection, and seeding of frontalis slings. C. parapsilosis is a commensal of human skin and can be acquired by nosocomial spread...
April 20, 2015: Ophthalmic Plastic and Reconstructive Surgery
D C Thamke, D K Mendiratta, A Dhabarde, A K Shukla
Engyodontium album is a rare and an unusual human pathogen. It is a common inhabitant of waste and moist material and frequently isolated from substrates such as paper, jute, linen and painted walls. This fungus grew within 3 days on SDA with chloramphenicol from corneal scrapping of a 70-year-old male farmer with a history of trauma by unknown vegetative matter. The fungus can be confused with Tritirachium sp and Beauveria sp.
April 2015: Indian Journal of Medical Microbiology
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