Exophiala (Wangiella) dermatitidis keratitis after keratoplasty

This is the first described case of keratitis caused by E. phaeomuriformis in a subarctic region, the first in Europe and, to our knowledge, the second reported case in the literature. It is important to remember that superficial corneal brown-pigmented infiltrates should raise the suspicion of an unusual fungal infection even in this climate. This is particularly important in patients with ocular surface disease treated with steroids and antibiotics for a long time.

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“…; Benaoudia et al. ). A patient with an E. dermatitis keratitis after laser in situ keratomileusis (Patel et al.…”

Section: Discussionmentioning

confidence: 97%

Exophiala phaeomuriformis keratitis in a subarctic climate region: a case report

Vicente

Domellöf

Byström

2017

Acta Ophthalmologica

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“…The most common extracutaneous site of involvement is the central nervous system; brain abscesses have been reported in patients both with (8) and without (6,7,9) cutaneous manifestations. Other reported systemic infections include septic arthritis after intra-articular steroid injection (13), post-traumatic endophthalmitis (12) or keratitis (11), native valve endocarditis in an intravenous drug user (14), peritonitis in a peritoneal dialysis patient (19), tenosynovitis (20), pneumonia (9, 10) and catheter-associated fungemia (17,18).…”

Section: Discussionmentioning

confidence: 99%

“…Although considered a saprophyte, it has infrequently been identi ed as the cause of human infections, including those of the skin (5), brain (6-8), lung (9, 10), eye (11,12), joints (13) and endocardium (14). Haase et al (15) rst reported an association between cystic brosis and sputum isolation of W. dermatitidis in 1990.…”

Section: Introductionmentioning

confidence: 99%

Sputum Isolation of Wangiella dermatitidis in Patients with Cystic Fibrosis

Diemert

Kunimoto

Sand

et al. 2001

Scandinavian Journal of Infectious Diseases

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We report a case of invasive fungal pulmonary infection in a cystic fibrosis patient. Clinical deterioration coincided with isolation of Wangiella dermatitidis from her sputum, and treatment with amphotericin B followed by voriconazole resulted in clinical improvement and sterilization of the sputum. This case suggests that W. dermatitidis may be an etiologic agent of invasive pulmonary disease in the cystic fibrosis population.

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“…Mycotic keratitis has also been reported to occur following lamellar (286) or penetrating (4,29,212,419) keratoplasty, following keratoplasty dehiscence repair (191), and secondary to the endophthalmitis that occurred after phacoemulsification and intraocular lens implantation surgery (88,417); all nine patients involved required surgery (therapeutic penetrating keratoplasty in seven, optical keratoplasty in one, and debridement in one) (Table 21). Four different yeast species (C. albicans, C. guilliermondii, C. parapsilosis, and Rhodotorula sp.)…”

Section: Fungal Ocular Infections After Ophthalmic Surgical Proceduresmentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

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Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors

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Exophiala (Wangiella) dermatitidis keratitis after keratoplasty

Cited by 15 publications

References 18 publications

Exophiala phaeomuriformis keratitis in a subarctic climate region: a case report

Exophiala phaeomuriformis keratitis in a subarctic climate region: a case report

Sputum Isolation of Wangiella dermatitidis in Patients with Cystic Fibrosis

Current Perspectives on Ophthalmic Mycoses

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