Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The increased incidence of fungal infections in the recent past has been attributed to the increase in the number of human immunodeficiency virus-positive and AIDS patients. Early diagnosis of mycoses in patients is crucial for prompt antifungal therapy. Immunological methods of diagnosis have not been found to be satisfactory, and recent research has been diverted to the use of PCR for the sensitive and early diagnosis at the molecular level. In the present study we targeted different regions of the rRNA gene to diagnose cases of mycotic keratitis and identify the causal agents. Six fungus-specific primers (primers ITS1, ITS2, ITS3, ITS4, invSR1R, and LR12R) were used, and the amplified products were analyzed by single-stranded conformation polymorphism (SSCP) analysis. Dendrograms of these SSCP patterns, prepared on the basis of Jaccard's coefficient, indicated that the PCR products obtained with primer pair ITS1 and ITS2 were the best for the identification of fungi. The results were confirmed by sequencing of the PCR products, and the approach was successfully tested experimentally for the detection of mycotic keratitis caused by Aspergillus fumigatus and was used for the diagnosis of fungal corneal ulcers in patients.
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PMID:Use of PCR targeting of internal transcribed spacer regions and single-stranded conformation polymorphism analysis of sequence variation in different regions of rrna genes in fungi for rapid diagnosis of mycotic keratitis. 1569 61

A case of mycotic keratitis caused by Bipolaris spicifera is reported. The corneal ulcer developed after 1 week of treatment with corticosteroids and antibiotics. Septate, branched, dematiaceous hyphal elements were detected in the corneal scrapings on two occasions and repeated cultures were positive for this fungus. The infection was resolved with natamycin and itraconazole although the corneal opacity remained and the patient is now waiting for a keratoplasty.
Mycoses 2005 Nov
PMID:Bipolaris keratomycosis. 1626 86

Penetrating keratoplasty carries an infectious risk. Its requirement for topical corticosteroid therapy facilitates fungal growth with resulting keratitis. Although progression of fungal keratitis to intraocular infection is uncommon, endophthalmitis resulting from keratitis usually has a poor visual prognosis. Fungal infection under these circumstances remains a diagnostic and therapeutic challenge. We report a complicated case of recurrent fungal keratitis with endophthalmitis following a contaminated penetrating keratoplasty that ultimately was controlled with a new treatment modality. Intrastromal corneal injections combined with intravitreal injection of amphotericin B led to the eradication of the corneal fungal plaques and the intraocular infection. Intrastromal corneal injections of amphotericin B may offer a less invasive, in-office alternative to repeat penetrating keratoplasty.
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PMID:Intracorneal injection of amphothericin B for recurrent fungal keratitis and endophthalmitis. 1634 45

We describe a patient with Pseudallescheria boydii keratitis. The treatment of mycotic keratitis remains difficult. This case demonstrates that identification and susceptibility testing should be rapidly performed. In cases of indolent keratitis, the possibility of fungal infection should be kept in mind.
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PMID:Pseudallescheria boydii keratitis. 1659 81

Fungal infection is rarely investigated in keratitis. The authors report five cases of fungal keratitis observed at the le Dantec University Teaching Hospital of Dakar, Senegal, involving two males and three females. Diagnosis was made by examination of smears and cultures of corneal scrapings revealing Candida albicans isolated in four patients and Acremonium strictium in another after 2 or 12 weeks of treatment with antibiotics, antivirals, or steroids. Povidone iodine 2.3% concentrated eye drop was used alone or with an azole for 4 a mean of weeks. All patients presented corneal scars. Fungal keratitis must be considered in presence of torpid corneal ulcer and corneal scraping must be systematically done. Topical povidone iodine alone or associated with azole may be an alternative fungal keratitis treatment in intertropical areas.
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PMID:[Fungal keratitis in an intertropical area: diagnosis and treatment problems. Advantage of local use of polyvidone iodine]. 1707 98

Mycotic keratitis is a devastating eye infection acquired after eye injury. Cetrimide at 15 and 20 mg ml(-1) produced no surviving Fusarium solani growth with minimal inhibitory concentration value of 0.10 mg ml(-1). Topical administration of three drops (0.3 ml) of cetrimide aqueous solution of 10 mg ml(-1) at pH 6.4 three times daily succeeded to cure human severe resistant F. solani keratitis in a time course of <3 weeks, and with complete healing after 6 weeks. Cetrimide-treated rabbit corneas section appeared with normal compact epithelium and endothelium with no vacuolation in Descemet's endothelial complex: an indication that cetrimide has no significant toxic effects. So, cetrimide at 10 mg ml(-1) may be effective and safe topical therapy in patients with mycotic keratitis, especially F. solani ulcers. Currently, there is no antimycotic drug with a good corneal penetration, which is safe and has a fungicidal activity.
Mycoses 2007 Jan
PMID:In vitro and in vivo antifungal activity of cetrimide (cetyltrimethyl ammonium bromide) against fungal keratitis caused by Fusarium solani. 1730 51

Azoles are extensively applied in agriculture and medicine, and a relationship between the development of azole resistance in agriculture and the development of azole resistance in clinical practice may exist. The maize pathogen Colletotrichum graminicola, causing cutaneous mycosis and keratitis, has been used to investigate the acquisition of resistance to an agricultural azole and the resulting cross-resistance to various medical antifungal agents. Azole-adapted strains were less sensitive to all azoles tested but showed increased sensitivity to caspofungin, amphotericin B, and nystatin. Viability staining and infection assays with excised human skin confirmed these data.
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PMID:Treatment of a clinically relevant plant-pathogenic fungus with an agricultural azole causes cross-resistance to medical azoles and potentiates caspofungin efficacy. 1762 Mar 78

The increased incidence of fungal infections in the recent past has been attributed to the increase in the number of human immunodeficiency virus-positive and AIDS patients. Early diagnosis of mycoses in patients is crucial for prompt antifungal therapy. The yield of clinical examination in the diagnosis of keratomycosis is 63-83% and KOH mount is 91%. This still highlights the limitation of routine clinical examination and smear examination, which is not performing 100% efficiently. It is for these 37%, 17% and 9% of cases, every day advanced technologies are called for. Those who deal with patient care are aware of certainties and uncertainties of results of clinical examination. The best reported figures at specialized centres might not translate into clinical practice. Another factor to be kept in mind is that many patients who come after secondary and tertiary referrals are already treated with antibiotics, antivirals, steroids and sometimes even antifungals that distort the clinical picture completely. Further, one has to consider as well the cases caused by yeast-like fungi, which resemble bacterial keratitis. Confirmation of diagnosis, not only in case of mycotic keratitis but also for other diseases, to initiate prompt and accurate therapy would avoid unnecessary and indiscriminate use of steroids/antibacterials/antivirals and antifungals.
Mycoses 2008 May
PMID:Mycotic keratitis: an overview of diagnosis and therapy. 1839 99

A 54-yr-old male, who was treated by chemotherapy for gastric cancer 15 months ago, presented to Yongdong Severance Hospital, Seoul, with complaints of pain in his right eye caused by a foreign body from the ground in the previous week. He had been treated with topical and oral antibacterial in addition to antifungal agents, but did not show significant clinical improvement. After a positive corneal culture with mold, topical amphotericin B was added to the initial regimen. The mold was identified as Scedosporium apiospermum by macroscopic and microscopic morphologies and the nucleotide sequences of a fungal PCR product showing 99% homology with those of S. apiospermum (EF151349). He recovered with good results at 25 days after corneal epithelial debridement. The early diagnosis of S. apiospermum keratitis is very important for proper treatment. It is recommended that molecular diagnostic methods such as fungal PCR and sequencing be done with conventional cultures whenever a fungal infection is suspected.
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PMID:[A case of Scedosporium apiospermum keratitis confirmed by a molecular genetic method]. 1872 81

Invasive aspergillosis is rare in immunocompetent people but contributes to significant morbidity and mortality in immunosuppressed patients. The majority (approximately 80%) of invasive Aspergillus infections is caused by Aspergillus fumigatus. The second most frequent (approximately 15-20%) pathogenic species is Aspergillus flavus and to a lesser extent, Aspergillus niger and Aspergillus terreus. Aspergillus flavus has emerged as a predominant pathogen in patients with fungal sinusitis and fungal keratitis in several institutions worldwide. To date, there has not been any publication exclusively reviewing the topic of A. flavus in the literature. This article reviews the microbiology, toxigenicity and epidemiology of A. flavus as well as describes the clinical characteristics, diagnosis and management of infections caused by this organism.
Mycoses 2009 May
PMID:Aspergillus flavus: an emerging non-fumigatus Aspergillus species of significance. 1920 51


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