Macroscopic Pigmentation in a Dematiaceous Fungal Keratitis

Berger, Steven T.; Katsev, Douglas A.; Mondino, Bartly J.; Pettit, Thomas H.

doi:10.1097/00003226-199105000-00014

Cited by 20 publications

(14 citation statements)

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“…The ulcers usually are central or paracentral in position with irregular or serrated edges. Colletotrichum keratitis progresses slowly compared to Aspergillus or Fusarium keratitis, and brown pigmentation may be noted in the ulcer bed as the fungus is a dematiaceous mold (1).…”

Section: Discussionmentioning

confidence: 99%

Colletotrichum truncatum: an Unusual Pathogen Causing Mycotic Keratitis and Endophthalmitis

Shivaprakash¹,

Appannanavar²,

Dhaliwal³

et al. 2011

J Clin Microbiol

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In recent years, the well-known plant pathogens of the Colletotrichum genus were increasingly reported to cause ophthalmic infections in humans. Among 66 species in the Colletotrichum genus, only a few are known to be pathogenic for humans. We report here five cases of ophthalmic infections due to Colletotrichum truncatum, a species never reported earlier to cause human infection. The isolates were identified by morphological characteristics and the sequencing of internal spacer regions of ribosomal DNA. The progress of lesions in those patients was slow compared to that of lesions caused by Aspergillus or Fusarium infections. The surgical management included total penetrating keratoplasty in patients with keratitis and pars plana vitrectomy in endophthalmitis. Two patients were treated additionally with intravitreal amphotericin B deoxycholate, one patient with oral itraconazole, and another patient with oral and topical fluconazole therapy. The present series therefore highlights the expanding spectrum of agents causing eye infections and the inclusion of C. truncatum as a human pathogen.Colletotrichum species are well-known plant pathogens in tropical and subtropical countries. The taxonomy and nomenclature of Colletotrichum species are confusing, even to scientists working in this field (11). Initially, the species were identified by the characteristic host specificity, location of isolation, and conidial morphology. Subsequently, based on morphological characteristics, host range (of plants), and phylogenetic analysis, the fungi in the genus Colletotrichum were systematically classified.

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Section: Discussionmentioning

confidence: 99%

Colletotrichum truncatum: an Unusual Pathogen Causing Mycotic Keratitis and Endophthalmitis

Shivaprakash¹,

Appannanavar²,

Dhaliwal³

et al. 2011

J Clin Microbiol

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“…[18][19][20] These studies have also hypothesized that pigmentation indicates lower virulence and less severe inflammation, and presence of fungal filaments superficially on the anterior stroma. 18,19,21 Our findings suggest that, in addition to being a diagnostic indicator of fungal keratitis, pigmentation of the corneal ulcer can also be a prognostic indicator for worse visual outcomes, contrary to prior hypotheses. By the time pigmented hyphae are visible on the cornea, the infection may have been present for a longer period of time and therefore has developed into a more severe ulcer.…”

Section: Macroscopic Pigmentation Is Typically Characteristicmentioning

confidence: 99%

Predictors of outcome in fungal keratitis

Prajna

Krishnan

Mascarenhas

et al. 2012

Eye

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Purpose To analyse predictors of clinical outcome in fungal keratitis. Methods Data was collected during a prospective, randomized, controlled, doublemasked clinical trial of treatment for fungal keratitis. Clinical features at presentation and demographics were collected at the enrolment visit for all patients. Pre-specified clinical outcomes included 3-month visual acuity and infiltrate/scar size, time to re-epithelialization, and corneal perforation. A separate multivariable model with each outcome as the dependent variable included all predictor variables.

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“…[8][9][10] Macroscopic pigmentation of corneal infiltrates is characteristic of Dematiaceous fungal keratitis. [3][4][5] The pigment is usually scattered on the ulcer bed. [3][4][5] However, this case presented with an unusual foreign body-like clinical picture.…”

Section: Commentmentioning

confidence: 99%

“…[3][4][5] The pigment is usually scattered on the ulcer bed. [3][4][5] However, this case presented with an unusual foreign body-like clinical picture. The brown corneal plaque was solitary, well defined, foreign body-like and could be easily separated from the ulcer base when taking a corneal scraping.…”

Section: Commentmentioning

confidence: 99%