Fungal keratitis caused by rare organisms

Abstract

PurposeTo report two rare cases of filamentous fungal keratitis.MethodsTwo non-consecutive patients presented with suspicious fungal keratitis. After performing the smear and culture, medical therapy was started for them. They underwent slit photography and in vivo confocal microscopy (IVCM) in their follow-up visits.ResultsThe patients were 33-year-old and 56-year-old farmer men. They both mentioned a history of ocular trauma by plants. During their follow-up visits, corneal infiltration density and fungal hyphae density decreased in slit-lamp biomicroscopy and IVCM, respectively. The corresponding organisms were Pseudallescheria boydii (P. boydii) and Colletotrichum coccodes.ConclusionsIt is important to be aware of these rare organisms and their antibiotic susceptibility. There was not any specific confocal feature for the presented fungal keratitis that was different from other filamentous fungal hyphae; however, confocal scan is a good choice to follow the response to the treatment.

Colletotrichum keratitis: A rare yet important fungal infection of human eyes

“…Five of our seven patients had trauma history, which agrees with findings in previous reports that ocular trauma was the primary risk factor for Colletotrichum keratitis . Because the conidia of Colletotrichum are not freely released, the traumatic implantation is essential for initiation of the infection .…”

“…Their ITS and ACT sequences are nearly identification to those of the type species of Five of our seven patients had trauma history, which agrees with findings in previous reports that ocular trauma was the primary risk factor for Colletotrichum keratitis. 2,[9][10][11][12][13][14]16,[19][20][21]23,25 Because the conidia of Colletotrichum are not freely released, the traumatic implantation is essential for initiation of the infection. 8,11,39 The other one patient had regular antineoplastic treat- However, all reported patients with C. truncatum, including previously documented six (Table S1) and our two cases, required surgical interventions, such as therapeutic keratoplasty and evisceration.…”

“…2,8,9 Cases of Colletotrichum keratitis, an infrequent cause of fungal keratitis, are mostly documented in case reports and small series. Species implicated in keratitis include C. dematium, [10][11][12][13][14] C. coccodes, 13,15,16 C. gloeosporioides, 9,[17][18][19][20] C. graminicola, 21,22 C. crassipes, 13 C. truncatum, 2,4,8 and a Colletotrichum isolate without identification to species level. [23][24][25] Only a few studies have diagnosed Colletotrichum keratitis based on nucleic acid sequence analyses, mainly sequencing the internal transcribed spacer (ITS) regions of ribosomal DNA.…”

Clinical Characteristics and Outcomes of Rare Fungal Keratitis Caused by Verticillium dahliae

“…More than 100 species have been reported as pathogens of fungal keratitis, Fusarium species are the most commonly isolated pathogens, followed by Alternaria and Aspergillus species, in Shandong Province, China [10][11]. In the recent years, the incidence of uncommon fungal keratitis caused by rare species with diverse morphology has greatly increased [12][13][14][15][16][17][18][19]. The current study described the first confirmed series of fungal keratitis cause by V. dahliae with detailed descriptions of clinical characteristics and treatment outcomes.…”

Recent advances on mycotic keratitis caused by dematiaceous hyphomycetes

“…2010; Tabatabaei et al . 2018). In developing countries like India, the traditional therapies used by rural people for ocular infections include the application of extracts of green leaves, banyan tree juice, goat and human breast milk, castor and coconut oil, and chicken blood (Thomas 2003).…”