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Fungal keratitis

Bhupesh Bagga, Savitri Sharma, Sai Jeevan Madhuri Guda, Ritu Nagpal, Joveeta Joseph, Kodiganti Manjulatha, Ashik Mohamed, Prashant Garg
BACKGROUND: Pythium insidiosum is a parafungus that causes keratitis resembling fungal keratitis. This study compares outcome in a large cohort of patients with P insidiosum keratitis treated with antifungal drugs, to a pilot group treated with antibacterial antibiotics. METHODS: Between January 2014 and December 2016, 114 patients with culture positive P insidiosum keratitis were included in the study. A subset of culture isolates was tested in vitro for response to nine antibacterial antibiotics by disc diffusion and E test...
March 15, 2018: British Journal of Ophthalmology
Jing Zhong, Lulu Peng, Bowen Wang, Henan Zhang, Saiqun Li, Ruhui Yang, Yuqing Deng, Haixiang Huang, Jin Yuan
Purpose: To investigate the expression and roles of type I and II interferons (IFNs) in fungal keratitis, as well as the therapeutic effects of tacrolimus (FK506) and voriconazole on this condition. Methods: The mRNA and protein expression levels of type I (IFN-α/β) and II (IFN-γ) IFNs, as well as of related downstream inflammatory cytokines (interleukin (IL)-1α, IL-6, IL-12, and IL-17), were detected in macrophages, neutrophils, lymphocytes, and corneal epithelial cells (A6(1) cells) stimulated with zymosan (10 mg/ml) for 8 or 24 h...
2018: Molecular Vision
Koji Kitazawa, Koichi Wakimasu, Kazuhito Yoneda, Bernie Iliakis, Chie Sotozono, Shigeru Kinoshita
Purpose: Fungal infections post keratoplasty due to contamination of the donor corneal graft have become important issues that need to be addressed. Here we report a case of fungal keratitis and endophthalmitis post penetrating keratoplasty (PKP) due to fungal contamination of the donor corneal graft. Observations: We present a 52-year-old male who underwent PKP with a donor corneal graft that was later found to be contaminated with fungus. At 4-weeks postoperative, infectious infiltrates suddenly appeared at the border between the host and donor corneal graft, and endophthalmitis concomitantly occurred...
April 2017: American Journal of Ophthalmology Case Reports
Emma C Davies, Mary K Daly, Donna Siracuse-Lee
Purpose: We report a rare case of Phialemonium obovatum fungal keratitis in a patient sustaining a corneal laceration from impact with a piece of moldy plaster. Observations: The patient was treated with topical voriconazole with resolution of active keratitis and formation of a stromal scar. The patient's final visual acuity was 20/20 in the affected eye. Conclusions and importance: There is only one other case of Phialemonium obovatum keratitis reported in the literature...
April 2017: American Journal of Ophthalmology Case Reports
Ziqian Zhu, Hongmin Zhang, Juan Yue, Susu Liu, Zhijie Li, Liya Wang
BACKGROUND: Fungal keratitis is one of the major causes of visual impairment worldwide. However, the effectiveness of corneal collagen cross-linking (CXL) for fungal keratitis remains controversial. In this study, we developed an in vitro and an in vivo models to assess the efficacy of CXL for Fusarium keratitis. METHODS: The effect of in vitro CXL fungicidal was evaluated on the cultures of Fusarium solani which were exposed to irradiation for different durations...
March 2, 2018: BMC Ophthalmology
Alice Y Matoba, Mukul K Divatia, Robert A Arguello, Paty Chevez-Barrios
PURPOSE: To report the effect of topical antibiotics moxifloxacin 0.3% and gentamicin 0.3% on the clinical efficacy of topical antifungal agent voriconazole 1% in cases of culture- or biopsy-proven fungal keratitis. METHODS: Two cases of fungal keratitis in which the addition of topical moxifloxacin or moxifloxacin and gentamicin led to an improved clinical response to topical voriconazole were reviewed retrospectively. RESULTS: One patient with clinical resistance of his fungal keratitis to both topical voriconazole and natamycin had resolution of his keratitis with the addition of topical moxifloxacin and gentamicin to voriconazole...
February 27, 2018: Cornea
Jun-Yi Wang, Dian-Qiang Wang, Xiao-Lin Qi, Jun Cheng, Li-Xin Xie
AIM: To evaluate the efficacy of modified corneal ulcer debridement in superficial fungal keratitis unresponsive to medications. METHODS: A total of 209 patients (209 eyes) with fungal keratitis, involving no more than 50% of the stromal depth and not responding to antifungal agents for 2wk, were recruited in this retrospective, noncomparative study. The patients were treated with modified corneal ulcer debridement. All visible corneal infiltrates were removed under an operating microscope to obtain a clean stromal bed and smooth incised edges...
2018: International Journal of Ophthalmology
Lei Wan, Jun Cheng, Jing Zhang, Nan Chen, Yan Gao, Li-Xin Xie
PURPOSE: To investigate risk factors, treatment strategies, and outcomes of endophthalmitis associated with severe fungal keratitis. METHODS: Data from 392 patients diagnosed with fungal keratitis were retrospectively examined. Patients had severe disease that was refractory to topical or systemic antifungal therapy, and the infection involved the endothelium or perforated the cornea. The incidence and risk factors for endophthalmitis, and treatment outcomes were evaluated...
February 22, 2018: Retina
Lindsay Machen, Felix Y Chau, Jose de la Cruz, Joel Sugar, Maria Soledad Cortina
PURPOSE: To present a case of Exophiala phaeomuriformis fungal keratitis to demonstrate the heightened concern for fungal infection in patients with a keratoprosthesis and to highlight the rare involvement of Exophiala phaeomuriformis. METHODS: Case report. RESULTS: Exophiala phaeomuriformis was identified in a susceptible patient 7 years after Boston type I keratoprosthesis (KPro) implantation. CONCLUSIONS: Although fungal infiltration after KPro placement does not represent a novel clinical infection, identification of the rare Exophiala species in a patient with a KPro has not been reported and provides an opportunity for reflection on fungal identification, prophylaxis, and prevention in this vulnerable patient population...
February 22, 2018: Cornea
Jing Zhong, Bowen Wang, Saiqun Li, Yuqing Deng, Haixiang Huang, Ling Chen, Jin Yuan
Fungal keratitis is a severe and common ocular infectious disease. The present study evaluated the efficiency of full-thickness conjunctival flap covering surgery with amniotic membrane transplantation (FCCS + AMT) as a transitional surgery for severe fungal keratitis. A total of 17 patients with severe fungal keratitis without corneal perforation underwent FCCS + AMT between January 2010 and December 2015. The pathogenic factors, preoperative diagnosis and postoperative prognosis of FCCS + AMT at 3 months were evaluated...
March 2018: Experimental and Therapeutic Medicine
Ananya Tupaki-Sreepurna, Vijayakishore Thanneru, Sangeetha Natarajan, Savitri Sharma, Anjana Gopi, Murugan Sundaram, Anupma Jyoti Kindo
Availability of molecular methods, gene sequencing, and phylogenetic species recognition have led to rare fungi being recognized as opportunistic pathogens. Fungal keratitis and onychomycosis are fairly common mycoses in the tropics, especially among outdoor workers and enthusiasts. The frequently isolated etiological agents belong to genera Candida, Aspergillus, and Fusarium. Within the genus Fusarium, known to be recalcitrant to prolonged antifungal treatment and associated with poor outcome, members of the Fusarium solani species complex are reported to be most common, followed by members of the Fusarium oxysporum SC and the Fusarium fujikuroi SC (FFSC)...
February 14, 2018: Mycopathologia
Kathryn J Ray, N Venkatesh Prajna, Prajna Lalitha, Revathi Rajaraman, Tiruvengada Krishnan, Sushila Patel, Manoranjan Das, Ranjeet Shah, Kavita Dhakhwa, Stephen D McLeod, Michael E Zegans, Nisha R Acharya, Thomas M Lietman, Jennifer Rose-Nussbaumer
PURPOSE: To identify fungal keratitis patients who are at risk of a poor outcome and may benefit from closer follow-up or more aggressive treatment. DESIGN: Secondary analysis of randomized clinical trial data. SUBJECTS: Patients presenting with a smear-positive filamentous fungal ulcer, visual acuity of 20/400 or worse, and who subsequently had a 6-day fungal culture performed at the Aravind Eye Care system (India), Lumbini Eye Hospital (Nepal), or Bharatpur Eye Hospital (Nepal)...
February 10, 2018: American Journal of Ophthalmology
S X Li, J T Wang, Y Jiang, X Wang, W Y Shi
Objective: To evaluate the efficacy of modified deep lamellar keratoplasty (DLKP) combined with antiviral medications for severe herpes necrotizing stromal keratitis. Methods: Retrospective case series study. Modified DLKP was performed in combination with antiviral medications in fifty patients (50 eyes) with severe necrotizing stromal keratitis, which was unresponsive to systemic and topical antiviral treatment for 1 week, at Shandong Eye Hospital. Before surgery, the operated eyes were examined using slit-lamp microscopy...
February 11, 2018: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Swati Singh, Ruchi Mittal, Purvasha Narang, Vikas Mittal
PURPOSE: To describe a rare co-occurrence of ocular surface squamous neoplasia (OSSN) in a patient with microbial keratitis. METHODS: Case report. RESULTS: We describe a 68-years female who developed ocular surface squamous neoplasia (OSSN) in an eye with culture proven severe fungal keratitis of 5 months duration, which progressed to endophthalmitis. She was managed with extended enucleation for left eye. Histopathology examination was consistent with squamous cell carcinoma of ocular surface with no corneal stromal/scleral/anterior chamber involvement...
February 8, 2018: International Ophthalmology
Hyun Jung Park, Soon Hee Kim, Hyung Woo Ju, Hyesook Lee, Yoonjin Lee, Sehyun Park, Heejun Yang, Sung-Jin Park, J Gary Eden, Jaewook Yang, Chan Hum Park
The clinical impact of microplasma jets on rabbit eyes infected by Candida albicans has been investigated. Arrays of such jets produce low-temperature plasma micro-columns suitable for ophthalmic therapeutics and fungal infections, in particular, and the technology is capable of being scaled to surface areas of at least 10 cm2 . Keratitis was induced in the right central corneas of rabbits, whereas the left eyes served as a normal group. The rabbits were divided into the plasma non-treated group (control) and plasma treatment group...
February 5, 2018: Scientific Reports
Hulya Nalcacioglu, Y Kamil Yakupoglu, Gurkan Genc, Nursen Belet, Sema Gulnar Sensoy, Asuman Birinci, Ozan Ozkaya
Renal transplant recipients are on long-term potent immunosuppressive therapy, which makes them highly vulnerable to opportunistic fungal infections. Dematiaceous, or dark-pigmented saprophytic fungi, are being increasingly seen as opportunistic pathogens of mycoses in immunosuppressed patients. One of these is Aureobasidium pullulans, which is a black yeast-like dematiaceous fungus found ubiquitously in the environment that can cause various opportunistic human infections. Most infections occur by traumatic inoculation, such as keratitis and cutaneous lesions; disseminated mycoses are very rare and occur only in severely immunocompromised patients...
February 1, 2018: Pediatric Transplantation
Priscila Dallé da Rosa, Claudete Locatelli, Karla Scheid, Diane Marinho, Lúcia Kliemann, Alexandre Fuentefria, Luciano Zubaran Goldani
Lasiodiplodia theobromae is a rare ocular pathogen. We report a patient with fungal keratitis caused by L. theobromae. The patient was a 75-year-old male, a farmer with diabetes type II, and no previous history of ocular trauma. Histopathology analysis revealed the presence fungi invading Descemet's membrane of the cornea. The fungus was characterized by septate, highly bulged fungal filaments involving full corneal thickness in the corresponding histopathology specimens. A dematiaceous mold was isolated and initally identified as L...
January 30, 2018: Mycopathologia
Bin Wang, Shuo Yang, Hua-Lei Zhai, Yang-Yang Zhang, Chun-Xia Cui, Jun-Yi Wang, Li-Xin Xie
AIM: To compare the clinical characteristics of infectious keratopathy in type 2 diabetes mellitus (T2DM) and non-diabetes mellitus (NDM) and to investigate risk factors for infectious keratopathy in T2DM patients. METHODS: Totally 230 patients with T2DM and 168 with NDM diagnosed as infectious keratopathy were hospitalized at Qingdao Eye Hospital from 2001 to 2015. Data including sex, age, occupation, season, smoking and alcohol consumption habits, duration between onset and treatments, duration of hospitalization were collected...
2018: International Journal of Ophthalmology
Felix Bongomin, Sara Gago, Rita O Oladele, David W Denning
Fungal diseases kill more than 1.5 million and affect over a billion people. However, they are still a neglected topic by public health authorities even though most deaths from fungal diseases are avoidable. Serious fungal infections occur as a consequence of other health problems including asthma, AIDS, cancer, organ transplantation and corticosteroid therapies. Early accurate diagnosis allows prompt antifungal therapy; however this is often delayed or unavailable leading to death, serious chronic illness or blindness...
October 18, 2017: Journal of Fungi (Basel, Switzerland)
Jamal Wadi, David W Denning
OBJECTIVE: To estimate the burden of fungal infections in Jordan for the first time. MATERIAL AND METHODS: Population data was from UN 2011 statistics and TB cases from WHO in 2012. Fewer than 100 patients with HIV were recorded in Jordan in 2013. Approximately 100 renal transplants and eight liver transplants are performed annually. There were 12,233 major surgical procedures in Jordan in 2013, of which 5.3% were major abdominal surgeries; candidemia was estimated in 5% of the population based on other countries, with 33% occurring in the ICU...
January 18, 2018: Journal of Fungi (Basel, Switzerland)
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