Contact lens associated keratitis due to Tintelnotia destructans

Tan, Shu Jin; Nure, Mariyam; Gardam, Dianne; McKnight, Charlotte; Boan, Peter; Clark, Benjamin M.

doi:10.1016/j.mmcr.2019.12.004

Cited by 5 publications

(6 citation statements)

References 15 publications

(24 reference statements)

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“…Antifungal susceptibility tests are helpful in choosing the most effective treatment [3,4]. In some reported cases, keratoplastia was required despite medical treatment [2].…”

Section: Discussionmentioning

confidence: 99%

“…Little is known about this fungi's association with ophthalmological conditions. T. destructans associated keratitis was rst described in 2016 and named after its ability to destroy toenails by forming delicate fruiting bodies within the hard nail substance [4]. Although fungal keratitis occurs worldwide, its etiology is strongly related to the geographical region, climatic condition, and socioeconomic status of an individual.…”

Section: Introductionmentioning

confidence: 99%

“…Coelomycetes colonize dead organic matter and water bodies in warm and tropical regions [4,5]. In Europe, the incidence of lamentous fungal keratitis is increasing, varying between 0.6 and 1.5 cases per million per year [1], with predisposing factors being contact lens wear, trauma, ocular surgery and topical steroids; half to two-thirds of these patients are contact lens-wearers.…”

Section: Introductionmentioning

confidence: 99%

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A rare case of fungal keratitis caused by Tintelnotia destructans

Barranca,

Caro-Magdaleno,

Mataix-Albert

et al. 2023

Preprint

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Background Fungal keratitis is a rare, potentially sight-threatening fungal infection of the cornea, and a major global cause of visual impairment and blindness. Tintelnotia destructans, a filamentous fungus, is an unusual virulent ocular pathogen. Little is known about this fungi’s association with ophthalmological conditions and there is no standardized treatment protocol in guidelines. Case presentation: We report a rare case of T. destructans-associated keratitis in a 45-year-old woman, without history of corneal trauma and a regular contact lenses user, presenting with eye discomfort and redness. Conjunctival hyperemia and a corneal abscess located inferiorly parapupilarly with an epithelial lesion was detected and topical ciprofloxacin eye drops was initiated. In vivo confocal microscopy (IVCM) revealed fungal hyphae growing perpendicularly through the corneal collagen lamellae, suggesting keratomycosis. Culture from corneal scrapings identified the hyphomycete as T. destructans. The diagnosed corneal abscess was treated successfully with natamycin and terbinafine, resulting in symptom regression. Conclusions T. destructans is an opportunistic pathogen causing severe keratomycosis with no standardized treatment. Early diagnosis using IVCM and fungal culture, guided by in vitro susceptibility testing, can allow prompt intervention.

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“…Antifungal susceptibility tests are helpful in choosing the most effective treatment [3,4]. In some reported cases, keratoplastia was required despite medical treatment [2].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A rare case of fungal keratitis caused by Tintelnotia destructans

Barranca,

Caro-Magdaleno,

Mataix-Albert

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Internal transcribed spacer (ITS) gene sequencing establishes a rapid and prompt diagnosis of fungal keratitis in refractory cases[ 21 ] and has been described in Pythium along with other non-sporulating molds. [ 22 23 24 25 26 27 28 29 30 31 32 33 ]…”

Section: Diagnosismentioning

confidence: 99%

“…Several new pathogenic fungi causing keratitis, with varying or suboptimal susceptibility to antifungal therapy, are emerging [ Table 2 ]. [ 23 24 25 26 27 28 29 30 31 32 33 34 35 45 46 47 48 49 50 51 52 ] Knowledge of the sensitivity profile of antifungals by antifungal susceptibility test (AFST) against various species helps in initiating appropriate treatment and improving the outcome. A recent study from South America reported A. fumigatus isolate from post-traumatic keratitis in a 27-year-old male worker carrying the substitution G54E at Cyp51Ap associated with itraconazole resistance, highlighting the possibility of mutation-induced resistance to common antifungal therapy.…”

Section: Emerging New Pathogenic Microbesmentioning

confidence: 99%

Update on diagnosis and management of refractory corneal infections

Agarwal

Khan

Vanathi

et al. 2022

Indian Journal of Ophthalmology

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Infectious keratitis is a medical emergency resulting in significant visual morbidity. Indiscriminate use of antimicrobials leading to the emergence of resistant or refractory microorganisms has further worsened the prognosis. Coexisting ocular surface diseases, delay in diagnosis due to inadequate microbiological sample, a slow-growing/virulent organism, or systemic immunosuppressive state all contribute to the refractory response of the ulcer. With improved understanding of these varied ocular and systemic factors contributing to the refractory nature of the microbes, role of biofilm formation and recent research on improving the bioavailability of drugs along with the development of alternative therapies have helped provide the required multidimensional approach to effectively diagnose and manage cases of refractory corneal ulcers and prevent corneal perforations or further dissemination of disease. In this review, we explore the current literature and future directions of the diagnosis and treatment of refractory keratitis.

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