Infectious Posterior Scleritis Caused by Pseudallescheria boydii

Taravella, Michael J.; Johnson, D. W.; Petty, John G.; Keyser, Robert B.; Foster, C. Stephen; Lundberg, Brita E.

doi:10.1016/s0161-6420(97)30142-0

Cited by 22 publications

(13 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In most cases, inoculation of spores in skin or soft tissue is due to penetrating trauma or surgery. Following ocular surgery, such as laser-assisted in situ keratomileusis (LASIK) and pterygium excision with and without adjuvant radiation therapy, cases of keratitis anterior and posterior scleritis, corneoscleritis, and sclerokeratitis caused by S. apiospermum and S. prolificans have been reported (227,302,303,424,436). Other possible routes of entry for these fungi are inhalation (203), Hickman catheters (482), and lumbar puncture (32,264).…”

Section: Epidemiology Of Human Infectionsmentioning

confidence: 99%

Infections Caused byScedosporiumspp

et al. 2008

View full text Add to dashboard Cite

SUMMARY Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii in patients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.

show abstract

Section: Epidemiology Of Human Infectionsmentioning

confidence: 99%

Infections Caused byScedosporiumspp

et al. 2008

View full text Add to dashboard Cite

show abstract

“…apiospermum: keratitis (34,79,247,360,377,430), scleritis (254,379), endophthalmitis (239,298), and orbital infections (16,176,264). S. prolificans: sclerokeratitis (19,202,370) Speciation of isolates reported to be S. prolificans may require confirmation by DNA sequencing (Guarro and Gené, letter)…”

Section: [Teleomorph Pseudallescheria Boydii]; S Prolificans [Formermentioning

confidence: 99%

“…2) has been isolated from soil, sewage, and polluted water and from the manure of farm animals (373). It has been reported to cause severe ocular infection following trauma by plant material, contact with polluted water, and immunosuppression (211,325,379,430). The fungus Scedosporium prolificans, which was first described as a human pathogen in 1984, has been reported as a cause of sclerokeratitis (202,370).…”

Section: Etiological Agents and Laboratory Diagnosis Of Ophthalmic Mymentioning

confidence: 99%

“…The outcome of scleritis due to S. apiospermum is also reported to be varied, with good results being obtained in some patients (254) and poor results being obtained in others (379). S. schenckii infection has been successfully treated with oral potassium iodide (50 mg/drop), 10 drops three times daily slowly increasing to 24 drops three times daily (Brunette and Stulting, Letter).…”

Section: Mycotic Scleritismentioning

confidence: 99%

“…Fungal scleritis has been reported to occur in at least 13 patients (Table 21) following various ophthalmic surgical procedures, including excision of pterygium (a fleshy conjunctival growth) without (379) or with beta irradiation (202,230,254,370) or cataract extraction (31,51,221), and after trabeculectomy (filtering surgery for glaucoma). For management of fungal scleritis, early debridement and culture, close microbiologic assistance, systemic antimicrobials for a prolonged period, and penetrating keratoplasty for perforation or incipient perforation are the measures that have been advocated (254).…”

Section: Fungal Ocular Infections After Ophthalmic Surgical Proceduresmentioning

confidence: 99%

See 2 more Smart Citations

Current Perspectives on Ophthalmic Mycoses

2003

View full text Add to dashboard Cite

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

show abstract

Oculomycosis

Thomas

Geraldine

2010

Topley &Amp; Wilson's Microbiology and Microbial Infections

View full text Add to dashboard Cite

Infectious Posterior Scleritis Caused by Pseudallescheria boydii

Cited by 22 publications

References 8 publications

Infections Caused byScedosporiumspp

Infections Caused byScedosporiumspp

Current Perspectives on Ophthalmic Mycoses

Oculomycosis

Contact Info

Product

Resources

About