A case of mycotic keratitis caused by Fusarium solani

Hamdan, Júnia Soares; Resende, Maria Aparecida de; Franzot, Sarah P.; Dias, Daniel Vieira; Viana, Evelin M.; Casali, Agnes Kiesling

doi:10.1590/s0036-46651995000200014

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Allescheria ) boydii , Sporothrix schenckii , Verticillium spp., Acremonium spp., Fusidium spp., Sterigmatocystis nigra , Paecilomyces lilacinus , Periconia keratitidis , Neurospora spp., Volutella spp., Glenospora spp., Penicillium spp., Penicillium citrinum , Penicillium spinulosum , Graphium spp., Fusarium solani , Fusarium nivale , Fusarium oxysporum, Candida albicans , Candida guilliermondii , Candida viswanathii , Candida krusei , Rhodotorula spp., Colletotrichum state of Glomerella cingulata , Acrophialophora fusispora , Phaeotrichoconis crotalariae , Helminthosporium , Neosartorya fischeri var. fischeri , Arthrobotrys oligospora , Trichophyton mentagrophytes , Epidermophyton floccosum 19–42 . Species of Aspergillus , Fusarium, and Candida have been found to be the most common agent.…”

Section: Worldwide Distributionmentioning

confidence: 99%

Mycotic keratitis: an overview of diagnosis and therapy

Shukla

Kumar

Keshava

2008

Mycoses

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The increased incidence of fungal infections in the recent past has been attributed to the increase in the number of human immunodeficiency virus-positive and AIDS patients. Early diagnosis of mycoses in patients is crucial for prompt antifungal therapy. The yield of clinical examination in the diagnosis of keratomycosis is 63-83% and KOH mount is 91%. This still highlights the limitation of routine clinical examination and smear examination, which is not performing 100% efficiently. It is for these 37%, 17% and 9% of cases, every day advanced technologies are called for. Those who deal with patient care are aware of certainties and uncertainties of results of clinical examination. The best reported figures at specialized centres might not translate into clinical practice. Another factor to be kept in mind is that many patients who come after secondary and tertiary referrals are already treated with antibiotics, antivirals, steroids and sometimes even antifungals that distort the clinical picture completely. Further, one has to consider as well the cases caused by yeast-like fungi, which resemble bacterial keratitis. Confirmation of diagnosis, not only in case of mycotic keratitis but also for other diseases, to initiate prompt and accurate therapy would avoid unnecessary and indiscriminate use of steroids/antibacterials/antivirals and antifungals.

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Section: Worldwide Distributionmentioning

confidence: 99%

Mycotic keratitis: an overview of diagnosis and therapy

Shukla

Kumar

Keshava

2008

Mycoses

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“…Common recognized risk factors include trauma with contaminated organic material, eye surgery, prolonged treatment with topical steroids, use of contaminated contact lenses and previous ocular surface pathology, as well as systemic diseases such as diabetes mellitus. A history of trauma by plant leaves occurs in 61% of cases of keratomycosis [10], although some have not reported a history of corneal trauma in their cases [11,12]. In this particular case presented, the patient developed the corneal infection without an obvious history of trauma, and any comorbidity but with a history of contact with juice of herbs during an indigenous healing practice, which was the most likely cause for the development of the fungal infection.…”

Section: Discussionmentioning

confidence: 91%

A case of fungal keratitis due to Fusarium solani after an indigenous healing practice

Ortega-Rosales¹,

Quizhpe-Ocampo

Montalvo-Flores

et al. 2019

IDCases

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Fusarium keratomycosis is a destructive eye infection that is difficult to treat and produces a poor outcome, which can affect healthy patients. Keratomycoses are rare and can be underdiagnosed, thus, direct microscopic examination and culture are essential for an early specific diagnosis and must be taken into consideration to establish the most effective treatment and avoid severe complications. Herein, we present a case of a healthy patient, who was diagnosed with Fusarium solani keratitis. He developed a corneal infection without an obvious history of trauma, and any comorbidity but with a history of contact with juice of herbs during an indigenous healing practice, which was the most likely cause for the development of the fungal infection. He was treated with intrastromal voriconazole and systemic itraconazole, with a good clinical course, however with sequelae of decreased visual acuity.

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Endophthalmitis Caused by Fusarium proliferatum

Ferrer¹,

Alió

Rodrı́guez³

et al. 2005

J Clin Microbiol

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Fusarium proliferatum caused endophthalmitis after cataract surgery. Diagnosis was established by classical microbiology and molecular biology methods (PCR and DNA typing). The treatment with local amphotericin B, oral ketoconazole, and topical natamycin was successful. CASE REPORTA 66-year-old man underwent cataract extraction and intraocular lens implantation in his right eye. Four months after surgery, he complained of eye discomfort and was prescribed a topical steroid (dexamethasone) and tobramicin. Fifteen days later, his symptoms persisted, and the eye began to show severe palpebral edema. Slit lamp examination showed conjunctival hyperemia, hypopyon, capsular fibrosis, and corneal edema, and the intraocular lens had moved to the nasal site. Intraocular pressure was 28 mm Hg, and fundus examination showed vitreous haze. An aqueous humor sample was taken using a 30-gauge needle following examination of the eye. Diagnostic techniques included standard microbiological tests (culture and stains) and PCR. The aqueous humor sample was cultured on several media including Columbia agar plates supplemented with 5% sheep blood chocolate agar, MacConkey agar, and thioglycolate broth and brain heart infusion broth (all media were from Biomérieux, biomérieux Sa, Marcy L'Etoile, France) at 37°C in ambient air. The sample was also inoculated into Sabouraud dextrose agar with chloramphenicol and incubated at 30°C. Two different PCRs were carried out: the first focused on bacterial 16S rRNA gene (16) amplification, and the second focused on specific detection of the fungal internal transcribed spacer (ITS)/5.8S DNA region (5). All the tests on the aqueous humor sample (stains, cultures, and PCRs) were negative. Next, a vitreous sample was taken, and microbiological and molecular tests were repeated. Direct smear of the vitreous sample showed septate hyphae of a filamentous fungus with neutrophils ( Fig. 1). PCR with specific fungal primers was positive, and PCR with bacterial primers was negative. This preliminary result was obtained 6 h after the sample was taken. Antifungal treatment was given as soon as the fungal hyphae were seen in the vitreous sample by direct smear.Intravitreal amphotericin B (5 g/0.1 ml) and oral fluconazole (200 mg/day) were administered the same day the sample was taken.Amplified DNA from fungal PCR was submitted for sequence analysis (PE Applied Biosystems, Foster City, Calif.) and compared to DNA sequences in the BLAST alignment program of the GenBank database (National Institutes of Health) and the EMBL fungal DNA database using Fasta3 sequence similarity searches, which allowed the species identification 48 h after the sample was obtained. DNA database comparison of the sequence showed 100% identity with Fusarium proliferatum (NRRL 31071; USDA Agricultural Research Service Collection, Peoria, Ill.), 99.8% identity with Fusarium fujikuroi, and 99.8 to 99.6% identity with Fusarium annulatum, all of which belong to the Gibberella fujikuroi complex (10, 26).When the molecular identification show...

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A case of mycotic keratitis caused by Fusarium solani

Cited by 4 publications

References 11 publications

Mycotic keratitis: an overview of diagnosis and therapy

Mycotic keratitis: an overview of diagnosis and therapy

A case of fungal keratitis due to Fusarium solani after an indigenous healing practice

Endophthalmitis Caused by Fusarium proliferatum

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