Fungal Keratitis in a Tertiary Hospital in Malaysia

Tze-Suen, Chow; Chew-Ean, Tan; Din, Norshamsiah Md

doi:10.7759/cureus.18389

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…The leading etiology of fungal keratitis in Europe is Candida spp. [ 19 , 20 ] but not Asia [ 21 – 24 ]. Immunosuppression is a significant risk factor for reported fungal keratitis in Europe [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and Rapidity of Potassium Hydroxide Mount and Modified Chicago Sky Blue 6B Stain with Potassium Hydroxide in Fungal Keratitis Detection

Warnnissorn,

Sawatdiwithayayong,

Surit

2024

Korean J Ophthalmol

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Purpose: To compare the efficacy and rapidity of direct microscopic detection of fungal elements from corneal ulcers between 10% potassium hydroxide (KOH) and 1% Chicago Sky Blue 6B (CSB) in 10% KOH (CSB-KOH).Methods: Thirty patients with clinically suspected fungal keratitis were recruited. Participants with impending corneal perforation were excluded. Two slides were smeared with corneal ulcer scrapings from the ulcer’s edge and base for comparison of fungal staining solutions. One slide was infused with KOH, and the other slide was filled with CSB-KOH. Additional scraping was collected for inoculation on Sabouraud dextrose agar for fungal culture. The sensitivity, specificity and rapidity of both stainings were analyzed.Results: The sensitivity of fungal culture, KOH, and CSB-KOH were 43.75% (95% confidence interval [CI], 19.75%–70.12%), 62.50% (95% CI, 35.43%–84.80%), and 87.50% (95% CI, 61.65%–98.45%), respectively. The specificity were 100% (95% CI, 69.15%–100%) of both stainings and fungal culture which analyzed from 16 fungal keratitis cases by laboratory and clinical diagnosis. Mean CSB-KOH examination time was quicker than KOH with the mean time difference of 5.6 minutes (95% CI, 3.22–7.98 minutes) and p-value < 0.001.Conclusions: CSB-KOH was more effective and faster than KOH in detecting fungal elements from corneal ulcers. Therefore, CSB-KOH may be beneficial in diagnosing fungal keratitis and preventing blindness. Moreover, to the best of our knowledge, this is the first use of CSB stain in fungal keratitis detection.

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Section: Discussionmentioning

confidence: 99%

“…Immunosuppression is a significant risk factor for reported fungal keratitis in Europe [ 19 , 20 ]. In contrast, the leading risk factor in Asia is trauma [ 1 , 21 , 24 ]. Our results resemble recent reports from Northern Thailand [ 23 , 25 ] that trauma is the leading risk factor for fungal keratitis.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Rapidity of Potassium Hydroxide Mount and Modified Chicago Sky Blue 6B Stain with Potassium Hydroxide in Fungal Keratitis Detection

Warnnissorn,

Sawatdiwithayayong,

Surit

2024

Korean J Ophthalmol

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Oral voriconazole monotherapy for fungal keratitis: efficacy, safety, and factors associated with outcomes

et al. 2023

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PurposeTo provide preliminary data on the efficacy and safety of oral voriconazole (VCZ) as a primary treatment for fungal keratitis (FK).MethodWe performed a retrospective histopathological analysis of data on 90 patients with FK at The First Affiliated Hospital of Guangxi Medical University between September 2018 and February 2022. We recorded three outcomes: corneal epithelial healing, visual acuity (VA) improvement, and corneal perforation. Independent predictors were identified using univariate analysis, and multivariate logistic regression analysis was used to identify independent predictive factors associated with the three outcomes. The area under the curve was used to evaluate the predictive value of these factors.ResultsNinety patients were treated with VCZ tablets as the only antifungal drug. Overall, 71.1% (n = 64) of the patients had extreme corneal epithelial healing, 56.7% (n = 51) showed an improvement in VA, and 14.4% (n = 13) developed perforation during treatment. Non-cured patients were more likely to have large ulcers (≥5 × 5 mm2) and hypopyon.ConclusionThe results indicated that oral VCZ monotherapy was successful in the patients with FK in our study. Patients with ulcers larger than 5 × 5 mm2 and hypopyon were less likely to respond to this treatment.

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Fungal Keratitis in a Tertiary Hospital in Malaysia

Abstract: Tze-Suen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 2 publications

References 17 publications

Efficacy and Rapidity of Potassium Hydroxide Mount and Modified Chicago Sky Blue 6B Stain with Potassium Hydroxide in Fungal Keratitis Detection

Efficacy and Rapidity of Potassium Hydroxide Mount and Modified Chicago Sky Blue 6B Stain with Potassium Hydroxide in Fungal Keratitis Detection

Oral voriconazole monotherapy for fungal keratitis: efficacy, safety, and factors associated with outcomes

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