Successful Treatment of Resistant Ocular Fusariosis With Posaconazole (SCH-56592)

Tu, Elmer Y.; McCartney, Daryl; Beatty, Richard F.; Springer, Kathryn; Levy, Jaime; Edward, Deepak P.

doi:10.1016/j.ajo.2006.10.048

Cited by 88 publications

(63 citation statements)

References 21 publications

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“…However, its corneal penetration is poor and has not been effective for deeper keratitis. 5 In addition, some fungal pathogens such as Fusarium, which has been reported as a common pathogen, can penetrate an intact Descemet membrane, resulting in endophthalmitis. 6 Therefore, early diagnosis and treatment are important in the proper management of fungal keratitis.…”

Section: Introductionmentioning

confidence: 99%

Prospective comparison between conventional microbial work-up vs PCR in the diagnosis of fungal keratitis

Tananuvat

Salakthuantee

Vanittanakom

et al. 2012

Eye

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Purpose The PCR was compared with routine microbial studies for the detection of fungal pathogens in clinically suspected fungal keratitis. Methods A prospective nonrandomized study was undertaken at a tertiary eye care centre to evaluate 30 eyes of 30 patients with presumed fungal keratitis, both fresh and treated. Corneal scrapings were performed on each patient. The specimens were analysed by a semi-nested PCR assay using fungalspecific primers. PCR products were cloned and sequenced for identification, and compared with a conventional microbial work-up (smear and culture). Results Of the 30 samples, the PCR showed positivity in 93.3%, culture in 40%, and potassium hydroxide in 20%. Of the 28 PCR-positive cases, 12 were culture-positive and 16 were culture-negative. Two samples were both PCR and culture test negative. Culture-negative samples were PCR-positive in 16 of 18 (88.9%) cases. The PCR did not yield any false-negative findings in a culturepositive specimen. Both common and uncommon aetiologic fungi have been identified by DNA sequencing analysis. Conclusion The PCR was able to detect fungal DNA in a high proportion of culturenegative cases. Technical considerations of the PCR process include extraction of artifacts and amplification of non-pathogenic DNA. Nonetheless, our findings suggest that the PCR can be a useful adjunct to smear and culture in the rapid diagnosis of fungal keratitis, particularly in cases of failed detection from routine procedures.

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Section: Introductionmentioning

confidence: 99%

Prospective comparison between conventional microbial work-up vs PCR in the diagnosis of fungal keratitis

Tananuvat

Salakthuantee

Vanittanakom

et al. 2012

Eye

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“…Topical voriconazole is increasingly favored among ophthalmologists because of its wide spectrum of coverage against yeasts and filamentous agents of fungal keratitis [39]. Topical and oral posaconazole have also been used with success in therapy of Fusarium keratitis, resistant to voriconazole [40,41]. We should see for clinical signs of improvement like diminution of pain, disappearance of satellite lesions, rounding out of the feathery margins of the ulcer and hyperplastic masses or fibrous sheets in the region of healing fungal lesions [42].…”

Section: Treatment Of Fungal Keratitismentioning

confidence: 99%

Fungal Keratitis - A Brief Overview

Malhotra¹

2015

OCR

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“…Combination of systemic antifungal medications with topical treatment was suggested for immunocompromised patients with severe infections (60). Treatment with oral posaconazole has been reported to be successful in those patients not responsive to voriconazole therapy (61). As an early antifungal therapy is necessary for treatment, injection of amphotericin B or voriconazole is warranted for cases infected by mold endophthalmitis (51,62).…”

Section: Treatmentmentioning

confidence: 99%

Management of Fungal Keratitis in Pediatric Patients

Badiee

Nejabat

Choopanizadeh

2017

Arch Pediatr Infect Dis

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Context: Fungal keratitis is an uncommon infection with high morbidity in pediatric patients. Trauma is the most common risk factor for infection in children. Thus, rapid diagnosis should be made by scoring clinical features and mycological examination. This review discusses the management of fungal keratitis in pediatric patients. Evidence Acquisition: In this narrative review, the most recently published data on pediatric fungal keratitis, respective prominent signs and symptoms, etiologic agents, diagnosis and treatment of this infection have been reviewed. Results: Laboratory methods such as investigation of smear by potassium hydroxide and staining and cultural and molecular methods can be helpful in the diagnosis. Treatment of this infection with improved outcome is challenging. Medical therapy (topical and systemic treatments) is the first choice of treatment, but early surgical intervention and removal of the infected tissues are critical for effective cure. Lack of response to these therapies requires corneal transplantation. Unfortunately, loss of useful vision rate was found in patients even with treatment by antifungal agents. Conclusions:The signs and symptoms of fungal keratitis are similar to those of other microbial keratitis. Use of diagnostic methods and early treatment are helpful for recovery in infected pediatric patients.

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Successful Treatment of Resistant Ocular Fusariosis With Posaconazole (SCH-56592)

Cited by 88 publications

References 21 publications

Prospective comparison between conventional microbial work-up vs PCR in the diagnosis of fungal keratitis

Prospective comparison between conventional microbial work-up vs PCR in the diagnosis of fungal keratitis

Fungal Keratitis - A Brief Overview

Management of Fungal Keratitis in Pediatric Patients

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