Infectious Keratitis Caused by Rare and Emerging Micro-Organisms

Sahay, Pranita; Goel, Shubhi; Nagpal, Ritu; Maharana, Prafulla K.; Sinha, Rajesh; Agarwal, Tushar; Titiyal, Jeewan S

doi:10.1080/02713683.2019.1708407

Cited by 36 publications

(40 citation statements)

References 118 publications

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“…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.…”

Section: Discussionmentioning

confidence: 95%

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

Huang

Zhang

Sun

et al. 2021

Preprint

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PurposeTo observe clinical characteristics and treatment outcomes of fungal keratitis cause by Verticillium dahliae. MethodsClinical data of 7 patients diagnosed as fungal keratitis cause by V. dahliae were retrospectively analyzed. The clinical manifestations, mycology, in vitro antifungal susceptibility, treatment regimens and prognoses of the patients were evaluated. ResultsAll 7 patients were farm worker, of which 5 cases were caused by plant trauma. The corneal ulcer had a round shape and a relatively limited range with the diameters mainly in the range of 2-7 mm. The stromal infiltration was mild, and had no pseudopodia, mossiness or endothelial plaques. Intact hyphaes were detected in corneal scrapings and confocal microscopy, isolates were identified by morphology and by sequencing the internal transcribed spacer region of ribosomal DNA. In vitro antifungal susceptibility testing showed that the most sensitive antifungal drug was Amphotericin B. In the 6 patients with an ulcer less than 2/3 of the corneal thickness, the ulcer healed after 18 days of antifungal treatment only in one eye. The other five patients underwent corneal ulcer debridement or conjunctival flap covering surgery. The remaining one patient with ulcer depth more than 2/3 of the corneal thickness underwent lamellar keratoplasty. ConclusionFungal keratitis caused by V. dahliae has typical signs of a mild inflammatory response, and is not sensitive to antifungal drugs. It is recommended that patients undergo corneal ulcer debridement as soon as possible to promote rapid healing of the ulcers.

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Section: Discussionmentioning

confidence: 95%

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

Huang

Zhang

Sun

et al. 2021

Preprint

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“…Corneal scrapings for staining and antimicrobial susceptibility test results to guide appropriate antimicrobial therapy are necessary for appropriate diagnosis. Antimicrobial susceptibility test results are extremely useful as drug resistance to routinely used anti-microbial drugs is common and we could end with non-responsive cases with the empirical treatment [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Infectious crystalline keratitis induced by Citrobacter

Khanam

Gujral

Khan

2021

GMS Ophthalmology Cases; 11:Doc09

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“…There is no conclusive information about the increase on the number of cases of Purpureocillium spp. infections in humans around the world 46,47 . The uncertain identification could be partly responsible, because it is crucial to offer an effective therapeutic management 13,47 .…”

Section: Discussionmentioning

confidence: 99%

“…infections in humans around the world 46,47 . The uncertain identification could be partly responsible, because it is crucial to offer an effective therapeutic management 13,47 . For example, in countries like Mexico, molecular identification of ocular fungal pathogens is an option just in a few cases.…”

Section: Discussionmentioning

confidence: 99%

Purpureocillium roseum sp. nov. A new ocular pathogen for humans and mice resistant to antifungals

Calvillo‐Medina

Ponce-Angulo

Raymundo

et al. 2020

Mycoses

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BackgroundInfectious keratitis is the main cause of preventable blindness worldwide, with about 1.5–2.0 million new cases occurring per year. This inflammatory response may be due to infections caused by bacteria, fungi, viruses or parasites. Fungal keratitis is a poorly studied health problem.ObjectivesThis study aimed to identify a new fungal species by molecular methods and to explore the possible efficacy of the three most common antifungals used in human keratitis in Mexico by performing in vitro analysis. The capacity of this pathogen to cause corneal infection in a murine model was also evaluated.MethodsThe fungal strain was isolated from a patient with a corneal ulcer. To identify the fungus, taxonomic and phylogenetic analyses (nrDNA ITS and LSU data set) were performed. An antifungal susceptibility assay for amphotericin B, itraconazole and voriconazole was carried out. The fungal isolate was used to develop a keratitis model in BALB/c mice; entire eyes and ocular tissues were preserved and processed for histopathologic examination.Results and conclusionThis fungal genus has hitherto not been reported with human keratitis in Mexico. We described a new species Purpurecillium roseum isolated from corneal infection. P roseum showed resistance to amphotericin B and itraconazole and was sensitive to voriconazole. In vivo study demonstrated that P roseum had capacity to developed corneal infection and to penetrate deeper corneal tissue. The global change in fungal infections has emphasised the need to develop better diagnostic mycology laboratories and to recognise the group of potential fungal pathogens.

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Infectious Keratitis Caused by Rare and Emerging Micro-Organisms

Cited by 36 publications

References 118 publications

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

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

Infectious crystalline keratitis induced by Citrobacter

Purpureocillium roseum sp. nov. A new ocular pathogen for humans and mice resistant to antifungals

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