Fungal keratitis management in a referral cornea center in Brazil

Bezerra, Fernanda Machado; Höfling-Lima, Ana Luísa; Oliveira, Lauro Augusto de

doi:10.5935/0034-7280.20200067

Cited by 3 publications

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“…41 Previous ocular surgeries (cataract surgery, penetrating keratoplasty, laser surgeries, etc.) have been increasingly recognized as an important risk factor for fungal keratitis in Brazil 18,39,63,64…”

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confidence: 99%

Fusarium keratitis in a Brazilian tropical semi‐arid area: Clinical–epidemiological features, molecular identification and antifungal susceptibility

Milanez,

de Souza,

Monteiro

et al. 2024

Mycoses

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BackgroundFungal keratitis is a severe eye infection that can result in blindness and visual impairment, particularly in developing countries. Fusarium spp. are the primary causative agents of this condition. Diagnosis of Fusarium keratitis (FK) is challenging, and delayed treatment can lead to serious complications. However, there is limited epidemiological data on FK, especially in tropical areas.ObjectivesThis study aimed to describe the clinical, laboratorial and epidemiological characteristics of FK in a tropical semi‐arid region of Brazil.Patients/MethodsAdult patients with laboratory‐confirmed FK diagnosed between October 2019 and March 2022 were evaluated. Fusarium isolates were characterized at molecular level and evaluated regarding antifungal susceptibility.ResultsA total of 226 clinical samples from patients suspected of keratitis were evaluated; fungal growth was detected in 50 samples (22.12%); out of which 42 were suggestive of Fusarium spp. (84%). Molecular analysis of a randomly selected set of 27 isolates identified F. solani species complex (n = 14); F. fujikuroi sensu lato (n = 6) and F. dimerum sensu lato (n = 7); a total of 10 haplotypes were identified among the strains. All but one Fusarium strains were inhibited by amphotericin B, natamycin and fluconazole. Most patients were male (71.42%; 30 out of 42), aged from 27 to 73 years old. Trauma was the most important risk factor for FK (40.47%; 17 out of 42). Patients were treated with antifungals, corticoids and antibiotics; keratoplasty and eye enucleation were also performed.ConclusionsThe study provided insights into the characteristics of FK in tropical regions and emphasized the importance of enhanced surveillance and management strategies.

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