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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Corneal scrapings from 698 clinically suspected cases of mycotic keratitis were investigated for evidence of fungal infection. Of these, 322 were found to be positive by direct examination and/or culture. The infection was predominantly seen in the age group 21-50. Men were more frequently affected than women. Majority of the patients were either agricultural workers or out door manual labourers and 66.8% of them gave a definite history of antecedent corneal trauma due to vegetable or soil matter. Asperyllus flavus was the commonest causal agent isolated from 55 cases (17.1%), followed by A. niger (13.7%), A. fumigatus (10.9%), A. terreus (1.2%), A. glaucus (0.9%), and Pseudoallescheria boydii (0.6%). The order of occurrence of the genera of fungi isolated was Aspergillus, Acremonium, Curvularia, Fusarium, Candida, Syncephalastrum, Penicillium, Aureobasidium, Drechslera, Cladosporium, Rhizopus, Alternaria, Mucor, Pseudoallecheria and lastly Paecilomyces and Trichoderma from one case each.
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PMID:Mycotic keratitis in Madras. 277 50

Fusarium is a ubiquitous fungus that commonly colonizes ulcerated, burned, or traumatized skin and may cause keratitis and onychomycosis in healthy hosts. Serious disseminated infection due to Fusarium has been reported with increasing frequency in immunocompromised patients. We describe a bone marrow transplant patient who developed fungal septicemia and disseminated skin nodules due to Fusarium solani. Fusarium should be recognized as a potential cause of deep fungal infection in immunocompromised patients.
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PMID:Disseminated Fusarium solani infection with cutaneous nodules in a bone marrow transplant patient. 306 58

In a retrospective review from 1972 through 1987 of patients with microbial keratitis, fungal infection occurred in four (4%) of 90 cosmetic or aphakic contact lens wearers and in four (27%) of 15 patients using a therapeutic soft contact lens. Predisposing factors included improper lens care by the refractive lens wearers and a chronic epithelial defect with topical corticosteroid use among the therapeutic lens wearers. The responsible organisms in the refractive lens group were Fusarium solani (two patients) and Cephalosporium and Paecilomyces (one patient each), and in the therapeutic lens group Candida (three patients) and Aspergillus (one patient). Filamentous fungi were more likely to be associated with cosmetic or aphakic lens wear, whereas yeasts were more frequently found with therapeutic lens use.
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PMID:Fungal keratitis in contact lens wearers. 319 50

We have reported 7 new cases of Bipolaris infection and 2 of Exserohilum infection, which demonstrate the capability of these 2 genera to cause invasive as well as "allergic" disease. As noted previously, it is likely that all of the cases of "Helminthosporium" and Drechslera infections reported in the literature were caused by Bipolaris or Exserohilum. Infections due to these 2 genera are probably more common than previously recognized. They should be included in the differential diagnosis of central nervous system and disseminated fungal disease, sinusitis, keratitis, peritonitis associated with continuous ambulatory peritoneal dialysis, and allergic bronchopulmonary disease. These various entities have distinct histopathologic characteristics. With disseminated disease in the immunocompromised patient, the most frequent findings are acute inflammation with prominent vascular invasion, thrombosis, and infarction. In contrast, granulomatous inflammation and leukocytoclastic vasculitis are seen in meningoencephalitis caused by these fungi. The histologic features of allergic bronchopulmonary disease and sinusitis are similar. A chronic inflammatory infiltrate of lymphocytes, plasma cells and eosinophils within edematous granulation tissue is found in addition to squamous metaplasia and thickening of the basement membrane. Infections caused by Bipolaris/Exserohilum and Aspergillus show many clinical and pathologic similarities despite the lack of taxonomic relationship between these fungi. Both cause disseminated disease in immunocompromised patients that is characterized by tissue necrosis and vascular invasion. Both cause central nervous system disease, osteomyelitis, and sinusitis and are associated with allergic bronchopulmonary disease. Sinusitis, the most common form of disease caused by Bipolaris and Exserohilum, occurs in otherwise healthy patients with nasal polyposis and allergic rhinitis. Although pathologic evidence of bone invasion may not be found, there frequently is radiographic evidence of invasive disease. Most patients who are treated initially with surgical debridement and amphotericin B have apparently been cured. However, longer follow-up will be necessary in these patients. Amphotericin B appears to be the treatment of choice for invasive infections caused by Bipolaris/Exserohilum species. Ketoconazole and other imidazole derivatives may also be effective in certain of the disease entities caused by these black moulds; however, their role has yet to be defined.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Phaeohyphomycosis caused by the fungal genera Bipolaris and Exserohilum. A report of 9 cases and review of the literature. 352 12

A highly reproducible quantitative model of fungal infection of the rabbit's corneal stromal was produced using multiple corneal microtrephination. Aspergillus flavus (K4/77), at a concentration of 10(6) spores per ml was systematically implanted into the trephine sites in the cornea, and the degree of corneal infection determined. By pre-inoculation and post-inoculation challenge of these cornea with 1% ketoconazole in arachis oil, the prophylactic potential and the therapeutic usefulness of ketoconazole was determined. Ketoconazole, acetyl-dichlorophenyl-imidazole, has a significant prophylactic potential in inhibiting the development of corneal stromal fungal lesions when it is administered to the cornea of New Zealand white male rabbits as a 1% solution in arachis oil for two consecutive times hourly for two hours before the inoculation of the rabbits cornea with an ocular pathogenic Aspergillus flavus. Ketoconazole also has a therapeutic effect in the reduction of well established A. flavus keratitis in rabbits. When administered as 1% solution in arachis oil for ten consecutive hours daily to well established A. flavus lesions of the cornea of New Zealand albino rabbits, ketoconazole took about sixteen days to cure all the corneal lesions. Finally, using a yeast nitrogen base liquid medium, the in vitro minimal inhibitory concentrations of ketoconazole to twenty-five various human ocular pathogenic fungal isolates were determined and used to recommend those fungi for which ketoconazole would be a good choice for therapy.
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PMID:Ketoconazole: a new imidazole antifungal agent has both prophylactic potential and therapeutic efficacy in keratomycosis of rabbits. 629 73

For laboratory diagnosis of mycotic keratitis, demonstration of fungal pathogens on direct microscopy and their isolation by culture is essential. The addition of Calcofluor white (CFW) stain to the diagnostic armamentarium has significantly increased the sensitivity of smear examination on direct microscopy. During a period of 1 year, 143 consecutive patients with corneal ulcers were investigated by direct microscopy with potassium hydroxide (KOH) wet mount, Calcofluor white stain and routine cultures of corneal scrapings. Fungi were detected as aetiological agents in 21 (15%) patients. Different species of the genera Aspergillus (35%), Fusarium (23%), Acremonium (12%), Paecilomyces (12%), Cladosporium (6%), Alternaria (6%) and Pseudallescheria (6%) were the common isolates. Calcofluor white stain on direct microscopy detected fungi in 20 (95.2%) patients in comparison with 15 (71.4%) patients by both KOH wet mount examination and culture. Calcofluor white stain was significantly more sensitive than KOH wet mount in demonstrating fungal pathogens.
Mycoses
PMID:Evaluation of Calcofluor staining in the diagnosis of fungal corneal ulcer. 750 53

We report a case of a severe Fusarium solani keratitis in a 82-year-old patient with a history of surgical trauma. Antimycotic therapy and keratoplasty led to markedly improved vision. Identification of the fungus was complicated by the fact that the isolate did not produce the typical macroconidia. The second case was a fatal disseminated Fusarium verticillioides infection in a 69-year-old patient during neutropenia after chemotherapy of acute myelogenous leukemia. The patient developed pneumonia, fever, skin lesions, myalgia, and fungaemia. The clinical signs, diagnosis and therapy of localized and disseminated Fusarium infections are outlined and discussed in view of the literature.
Mycoses
PMID:Hyalohyphomycoses due to Fusarium spp.--two case reports and review of the literature. 763 84

Five recent professional liability claims involving the cornea are reviewed, arising from five unusual conditions: fungal infection following corneal abrasion with a tree branch; herpes simplex-induced neurotrophic keratitis resulting from contact lens wear; corneal necrotization caused by lime particulate matter splashed into the eye; siderosis-related retinal detachment secondary to a penetrating iron foreign body; and fluctuating acuity, halos, and flare resulting from radial keratotomy. Emphasis is on how these claims might have been avoided.
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PMID:Five liability claims involving the cornea and how they could have been prevented. 776 21

Histopathology was compared to culture results and cytology from horses with corneal stromal abscess at the Auburn University and the Ohio State University Veterinary Teaching Hospitals. Significant bacteria were not isolated in culture or seen on histopathology in any of the horses. Although most bacteria infecting equine corneas can be isolated with blood and MacConkey's agars, failure to detect bacterial growth may not rule out infection because anaerobic or intracellular bacteria would not be isolated. The inability to visualise bacterial organisms on histological sections did not rule out their presence in the tissue, because there is often destruction of bacteria by neutrophils, macrophages and antibiotic therapy greatly reducing their numbers. Fungal keratitis was diagnosed by histopathology in 4 of 11 eyes (36%) and keratitis with no aetiological agent in 7 of 11 eyes (64%). Nine of 11 horses (82%) had a prominent neutrophilic stromal infiltrate and 2 (18%) had a predominantly pyogranulomatous reaction. Two of the 4 lesions that showed histological evidence of fungal infection were positive for identifiable fungi on culture and cytology. Fungal cultures of the other 2 cases with histological evidence of mycotic keratitis were negative or grew unidentifiable fungi which were considered pathogenic because, on histopathological sections, fungal hyphae were found deep in the corneal stroma surrounded by an inflammatory reaction. In 3 of 6 cases where fungi were recovered on culture, they were considered contaminants based on lack of evidence of organisms in histopathological sections. Histopathology and the use of special stains were important in the interpretation of culture and cytology results.
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PMID:Histological findings in corneal stromal abscesses of 11 horses: correlation with cultures and cytology. 788 13

We report the frequency and type of infectious ocular complications following orthotopic liver transplantation (OLT) and review diagnostic and therapeutic strategies. During the period September 1988 through November 1994, 684 patients underwent OLT at Mount Sinai Hospital (New York). Nine orthotopic liver transplant patients (1.3%) developed ocular infections: Candida albicans endophthalmitis (2), Aspergillus fumigatus endophthalmitis (1), cytomegalovirus retinitis (4), herpes simplex virus keratitis (1), and varicella-zoster virus panophthalmitis (1). The mean time from OLT to ocular symptoms was 42 days for patients with fungal infections and 128 days for patients with viral infections. Blurred vision was the commonest symptom (five of nine cases). The mean duration of follow-up was 2 years (range, 33 days to 5 years). Permanent loss of vision occurred in three patients, five had improvement in visual acuity, and one died of disseminated aspergillosis 33 days after OLT. Infectious ocular complications following OLT may occur as isolated events or with disseminated disease. Fungal infections occur earlier (mean, 42 days after OLT) than viral infections (mean, 4 months after OLT). The clinical presentation may be atypical; aggressive vitreoretinal procedures and serial examinations may be required to establish the diagnosis. Cytomegalovirus retinitis in orthotopic liver transplant patients may not require life-long maintenance therapy with antiviral agents.
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PMID:Infectious ocular complications in orthotopic liver transplant patients. 919 78


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