Fungal infections of the cornea

Thomas, Philip A.

doi:10.1038/sj.eye.6700557

Cited by 379 publications

(324 citation statements)

References 48 publications

Supporting

Mentioning

292

Contrasting

Unclassified

Order By: Relevance

“…In most studies, Fusarium species and Aspergillus species were the most common fungal organisms [26]. In this study, Fusarium species was the most common organism (33%), followed by Aspergillus species (28%).…”

Section: Discussionmentioning

confidence: 54%

Clinical and microbiological characteristics of corneal ulcers in a Thai referral center

2014

View full text Add to dashboard Cite

Background: There are regional variations in causative organisms and epidemiologic patterns of corneal ulcers. It is essential to review periodically in terms of epidemiology and the microbial keratitis profiles that occur in a specific region in order to develop a comprehensive strategy for diagnosis and management of corneal ulcers. Objective: To review the epidemiology, predisposing factors, microbiological characteristics and visual outcomes in corneal ulcers at a referral center in Thailand. Methods: A retrospective review of patients with clinically diagnosed corneal ulcers presenting between January 2006 and December 2010 was performed. Results: A total of 159 patients (159 eyes) were analyzed. Ninety-one cases (57.2%) were in men. The mean age of the patients was 43.0 ± 20.0 years. The most common predisposing factor was ocular trauma found in 72 eyes (45%). Culture was grown from 123 eyes and results were positive in 52%. The most frequent causative organisms were bacteria (72%), followed by fungus (28%). The most common bacteria was Pseudomonas aeruginosa (55%) and most common fungus was Fusarium species (33%). In a comparison between fungal and bacterial groups, the latter was more likely to be associated with contact lens wear (p = 0.05). The hospitalization time for the fungal group was significantly longer than for the bacterial group (p = 0.001). The posttreatment corrected visual acuity equal to or better than 20/200 was found significantly more commonly in the bacterial group than in the fungal group (p = 0.031). While therapeutic keratoplasty was significantly higher in the fungal group than in the bacterial group (p = 0.048). Conclusion: Fungal keratitis was more severe than bacterial keratitis resulting in longer hospitalization time, poorer visual acuity, and with more chance to have therapeutic keratoplasty.

show abstract

Section: Discussionmentioning

confidence: 54%

Clinical and microbiological characteristics of corneal ulcers in a Thai referral center

2014

View full text Add to dashboard Cite

show abstract

“…The first step of quick lab diagnosis for confirmation is scraping or biopsy of infected lesion and investigating the direct microscopic smear detection by potassium hydroxide (KOH) or staining (8). Corneal biopsy may be required if smears and cultures of scraping materials are negative and clinical improvement is absent after 3 to 4 days.…”

Section: Direct Studymentioning

confidence: 99%

“…Unfortunately, significant visual impairment has been observed even with early treatment by systemic/topical antifungal agents. Medical therapy (topical and systemic treatments) is the first choice of treatment, but it sometimes fails, and urgent surgical intervention is warranted (8). Lack of response to these therapies requires corneal transplantation (4).…”

Section: Treatmentmentioning

confidence: 99%

“…There are no clinical trial studies about Candida keratitis, and evidence of the treatment of endogenous infection was reported in the form of case reports. The treatment of choice for Candida infection could be topical amphotericin 0.15% (0.1% -0.3%), topical capsofungin 0.5%, econazole 1%, and fluconazole 2%, moreover, alternatives include natamycin 5% and clotrimazole 1% (8,32). Capsofungin is more expensive and its use is limited.…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Management of Fungal Keratitis in Pediatric Patients

Badiee

Nejabat

Choopanizadeh

2017

Arch Pediatr Infect Dis

View full text Add to dashboard Cite

Context: Fungal keratitis is an uncommon infection with high morbidity in pediatric patients. Trauma is the most common risk factor for infection in children. Thus, rapid diagnosis should be made by scoring clinical features and mycological examination. This review discusses the management of fungal keratitis in pediatric patients. Evidence Acquisition: In this narrative review, the most recently published data on pediatric fungal keratitis, respective prominent signs and symptoms, etiologic agents, diagnosis and treatment of this infection have been reviewed. Results: Laboratory methods such as investigation of smear by potassium hydroxide and staining and cultural and molecular methods can be helpful in the diagnosis. Treatment of this infection with improved outcome is challenging. Medical therapy (topical and systemic treatments) is the first choice of treatment, but early surgical intervention and removal of the infected tissues are critical for effective cure. Lack of response to these therapies requires corneal transplantation. Unfortunately, loss of useful vision rate was found in patients even with treatment by antifungal agents. Conclusions:The signs and symptoms of fungal keratitis are similar to those of other microbial keratitis. Use of diagnostic methods and early treatment are helpful for recovery in infected pediatric patients.

show abstract

“…The prevalence of individual pathogens largely depends on geographical and climatic factors. Fungal keratitis occurs mainly in the warm climates and coincides with seasonal increase in temperature and humidity (Saha and Das, 2006 (Thomas, 2003). Fusarium spp.…”

Section: And Sharma Et Al 1993)mentioning

confidence: 99%

Epidemiological Characteristics and Laboratory Diagnosis of Fungal Keratitis in Patients with Corneal Ulcer in Riyadh, Saudi Arabia

El-Tahtawi¹

2015

CMR

View full text Add to dashboard Cite

Abstract:Corneal blindness is a major health problem worldwide and infectious keratitis is one of the predominant causes.The incidence of fungal keratitis has increased over the last few years. Keeping this in mind, this study was conducted to evaluate the frequency of positive fungal cultures in infectious keratitis and of the various fungal species identified as etiologic agents in patients with corneal ulcer attending the ophthalmic departments of 3 hospitals in Riyadh. Corneal scrapings from 100 patients of corneal ulcer with suspected fungal etiology were subjected to direct examination by 10% KOH and lactophenol cotton blue mount. Also swabs of diseased eyes were taken with sterilized swabs. The specimens were also inoculated directly on to Sabouraud's dextrose agar in C-shaped streaks. From 100 patients of corneal ulcer investigated, only 52% of patients were positive. Males were more commonly affected than females (69.23% and 30.76%), respectively. The age of patients was ranged from 28-55 years. 18 (34.61%) patients with fungal keratitis were laborers, 15 (28.84%) teachers, 7 (13.46%) housewives, 6 (11.53%) shepherds and 6 (11.53%) were civil engineers. Corneal trauma with stone chips and metal splinters appeared to be the most common predisposing factors of fungal keratitis (30.76%) followed by ocular surgery and corneal disease (26.92%). Of 52 positive patients with corneal ulcer surveyed the most important causative agents of fungal keratitis were Aspergillus spp. (44.23%), followed by Candida spp. (17.30%) and Fusarium spp. (17.30%). Because of serious consequences of infectious keratitis, it is important to know the exact etiology of fungal keratitis to institute appropriate therapy in time. Laboratory confirmation should be before pre scribing corticosteroids and antifungal.

show abstract

Fungal infections of the cornea

Abstract: Purpose To describe key aspects of fungal infections of the cornea, which constitute an important eye problem in outdoor workers in tropical and subtropical regions.

Cited by 379 publications

References 48 publications

Clinical and microbiological characteristics of corneal ulcers in a Thai referral center

Clinical and microbiological characteristics of corneal ulcers in a Thai referral center

Management of Fungal Keratitis in Pediatric Patients

Epidemiological Characteristics and Laboratory Diagnosis of Fungal Keratitis in Patients with Corneal Ulcer in Riyadh, Saudi Arabia

Contact Info

Product

Resources

About