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Mycotic keratitis

N Venkatesh Prajna, Tiruvengada Krishnan, Revathi Rajaraman, Sushila Patel, Ranjeet Shah, Muthiah Srinivasan, Lumbini Devi, Manoranjan Das, Kathryn J Ray, Kieran S O'Brien, Catherine E Oldenburg, Stephen D McLeod, Michael E Zegans, Nisha R Acharya, Thomas M Lietman, Jennifer Rose-Nussbaumer
Importance: Fusarium keratitis is common and often results in poor outcomes. No new treatments since natamycin have become available. Objective: To explore the role of adjuvant oral voriconazole on clinical outcomes in Fusarium keratitis. Design, Setting, and Participants: In this prespecified subgroup analysis of a multicenter, double-masked, placebo-controlled randomized clinical trial, 240 patients from the Aravind Eye Care System in India, the Lumbini Eye Hospital and Bharatpur Eye Hospital in Nepal, and the University of California, San Francisco, who had culture-positive fungal ulcer and baseline visual acuity of 20/400 or worse were randomized to receive oral voriconazole vs placebo...
April 20, 2017: JAMA Ophthalmology
H C Gugnani, D W Denning, R Rahim, A Sadat, M Belal, M S Mahbub
In Bangladesh there are several published papers on superficial mycoses. Deep mycoses are also recognized as an important emerging problem. Here, we estimate the annual incidence and prevalence of serious fungal infections in Bangladesh. Demographic data were obtained from world population reports and the data on TB and HIV extracted from the online publications on tuberculosis in Bangladesh and Asia Pacific research statistical data information resources AIDS Data HUB. All the published papers on fungal infections in Bangladesh were identified through extensive search of literature...
February 4, 2017: European Journal of Clinical Microbiology & Infectious Diseases
Abhishek Binnani, Priyanka Soni Gupta, Ankur Gupta
AIM AND OBJECTIVES: Mycotic keratitis, with its diverse clinical presentation and difficulties in treatment, makes it a challenging task for clinicians and an important object of study. The aim of present study was to determine the frequency of occurrence and epidemiological association with identification of fungal isolates from mycotic keratitis cases. MATERIALS AND METHODS: This was a prospective and observational study conducted in Mycology Laboratory, Department of Microbiology, S...
December 29, 2016: Mycopathologia
Elif Erdem, Meltem Yagmur, Hazal Boral, Macit Ilkit, Reha Ersoz, Seyedmojtaba Seyedmousavi
We investigated the clinical and mycological characteristics of four cases of mycotic keratitis caused by Aspergillus flavus that occurred from July 2014 to May 2015 at Çukurova University Hospital, Adana, Turkey. In a 10-month period, a total of 64 corneal smear/scrapings were examined from patients with suspected mycotic keratitis. Fungal cultures were positive in six of these patients, indicating a 9.4% incidence of mycotic keratitis in this region, including four cases of A. flavus and two cases of Fusarium spp...
April 2017: Mycopathologia
Jeyalakshmi Kandhavelu, Naveen Luke Demonte, Venkatesh Prajna Namperumalsamy, Lalitha Prajna, Chitra Thangavel, Jeya Maheshwari Jayapal, Dharmalingam Kuppamuthu
Aspergillus flavus and Fusarium sp. are primary causative agents of keratitis that results in corneal tissue damage leading to vision loss particularly in individuals from the tropical parts of the world. Proteins in the tear film collected from control and keratitis patients was profiled and compared. A total of 1873 proteins from control and 1400 proteins from patient tear were identified by mass spectrometry. While 847 proteins were found to be glycosylated in the patient tear, only 726 were glycosylated in control tear...
January 30, 2017: Journal of Proteomics
N Venkatesh Prajna, Tiruvengada Krishnan, Revathi Rajaraman, Sushila Patel, Muthiah Srinivasan, Manoranjan Das, Kathryn J Ray, Kieran S O'Brien, Catherine E Oldenburg, Stephen D McLeod, Michael E Zegans, Travis C Porco, Nisha R Acharya, Thomas M Lietman, Jennifer Rose-Nussbaumer
Objective: To compare oral voriconazole with placebo in addition to topical antifungals in the treatment of filamentous fungal keratitis. Design, Setting, and Participants: The Mycotic Ulcer Treatment Trial II (MUTT II), a multicenter, double-masked, placebo-controlled, randomized clinical trial, was conducted in India and Nepal, with 2133 individuals screened for inclusion. Patients with smear-positive filamentous fungal ulcers and visual acuity of 20/400 (logMAR 1...
December 1, 2016: JAMA Ophthalmology
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: Three hundred twenty-three fungal ulcer cases with an enrolment 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...
December 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...
November 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...
2017: 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...
July 2016: 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
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