Keratomycosis after cataract surgery

“…The major predisposing condition to A. flavus keratitis is trauma, generally with plant material (Gugnani et al, 1978;Khairallah et al, 1992;Wong et al, 1997;Cheikh-Rouhou et al, 2001). In some cases A. flavus keratitis was reported after laser and cataract surgery (Sridhar et al, 2000;Mendicute et al, 2000). Fungal endophthalmitis has rarely been associated with A. flavus (Lance et al, 1988;Demicco et al, 1984;Cameron et al, 1991).…”

Section: Keratitis and Endophthalmitismentioning

confidence: 99%

Aspergillus flavus: human pathogen, allergen and mycotoxin producer

et al. 2007

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Aspergillus infections have grown in importance in the last years. However, most of the studies have focused on Aspergillus fumigatus, the most prevalent species in the genus. In certain locales and hospitals, Aspergillus flavus is more common in air than A. fumigatus, for unclear reasons. After A. fumigatus, A. flavus is the second leading cause of invasive aspergillosis and it is the most common cause of superficial infection. Experimental invasive infections in mice show A. flavus to be 100-fold more virulent than A. fumigatus in terms of inoculum required. Particularly common clinical syndromes associated with A. flavus include chronic granulomatous sinusitis, keratitis, cutaneous aspergillosis, wound infections and osteomyelitis following trauma and inoculation. Outbreaks associated with A. flavus appear to be associated with single or closely related strains, in contrast to those associated with A. fumigatus. In addition, A. flavus produces aflatoxins, the most toxic and potent hepatocarcinogenic natural compounds ever characterized. Accurate species identification within Aspergillus flavus complex remains difficult due to overlapping morphological and biochemical characteristics, and much taxonomic and population genetics work is necessary to better understand the species and related species. The flavus complex currently includes 23 species or varieties, including two sexual species, Petromyces alliaceus and P. albertensis. The genome of the highly related Aspergillus oryzae is completed and available; that of A. flavus in the final stages of annotation. Our understanding of A. flavus lags far behind that of A. fumigatus. Studies of the genomics, taxonomy, population genetics, pathogenicity, allergenicity and antifungal susceptibility of A. flavus are all required.

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“…Dr Phillip Thomas discusses these in detail elsewhere in this book. Post-operative ophthalmologic infections have been described following penetrating keratoplasty [85][86][87], radial keratotomy [88][89][90][91], excimer laser photorefractive keratectomy [92], laser-assisted in situ keratomileusis [93][94][95][96], pterygium excision [97,98], hydroxyapatite orbital implant surgery [99], cataract surgery [81,82,[100][101][102][103][104][105][106][107][108][109], scleral buckling procedures [110,111], sutureless surgery [112,113] and trabeculectomy [101,114]. Sampling at the site of infection provides the best chance of obtaining a positive culture [93,[115][116][117].…”

Section: Aspergillosis Following Ophthalmological Surgeriesmentioning

confidence: 99%

Aspergillosis in Surgical Patients

Pasqualotto

2009

Aspergillosis: From Diagnosis to Prevention

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Most physicians will promptly consider the possibility of invasive aspergillosis in high-risk patients in the presence of an appropriate clinical syndrome. Aspergillosis will however only rarely be listed amongst the possible aetiologies of surgical site infections, although hundreds of cases have been published so far. This chapter reviews the current literature on post-operative aspergillosis. A few illustrative clinical cases are also shown. In most patients, the source was presumed to be airborne infection during the surgical procedure. Diagnosis relies on a high index of suspicion and treatment usually requires a combination of medical and surgical interventions. Prevention of post-operative aspergillosis requires special care with the ventilation system in the operating room.

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Keratomycosis after cataract surgery

Abstract: The presence of fungi in corneal ulcers that develop after cataract surgery should be considered. Initiation of early treatment determines the prognosis. Among the therapeutic options, collagen shields soaked in amphotericin B may be effective.

Cited by 23 publications

References 19 publications

Spectrum of clear corneal incision cataract wound infection

Spectrum of clear corneal incision cataract wound infection

Aspergillus flavus: human pathogen, allergen and mycotoxin producer

Aspergillosis in Surgical Patients

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