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

Ocular trauma from nylon line lawn trimmers is becoming more prevalent. Previous case reports have described penetrating trauma caused by these tools. We managed three cases of fungal keratitis caused by injuries from nylon line trimmers. Fungal keratitis should be strongly considered as the cause of any corneal ulcer related to trauma from a nylon line lawn trimmer.
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PMID:Fungal keratitis from nylon line lawn trimmers. 141 54

As Jones has emphasized, the successful management of microbial keratitis, fungal or otherwise, necessitates five steps: (1) clinical suspicion and clinical diagnosis; (2) performing the proper laboratory procedures; (3) initiating antimicrobial therapy based on the results of laboratory studies; (4) modifying the initial therapy based on the clinical response; and (5) deciding correctly when and how to terminate therapy. Keratomycosis poses special diagnostic and therapeutic challenges for ophthalmologists because of its low incidence, and its resistance to treatment, because of the lack of antifungal agents with good penetration into the eye, and because of the difficulties in obtaining meaningful in vitro drug susceptibility results for fungal isolates. We believe, however, that ophthalmologists are now diagnosing keratomycosis earlier and treating it more effectively.
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PMID:Fungal keratitis. 146 Feb 66

Mycotic keratitis caused by Arthrobotrys oligospora is reported in a 62-year-old Indian male patient. The diagnosis was made by direct microscopic examination, isolation of large quantities of the fungus on multiple media and the response of the lesion to an antifungal compound. This is believed to be the first documented case of keratitis due to an Arthrobotrys species.
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PMID:Keratitis due to Arthrobotrys oligospora Fres. 1850. 236 31

A dog with exposure keratopathy developed secondary bilateral keratitis from which Aspergillus sp and Curvularia sp were identified. Mycotic keratitis, while rare in the dog, should be considered in the differential diagnosis of keratitis.
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PMID:Mycotic keratitis in a dog: concurrent Aspergillus sp and Curvularia sp infections. 403 17

A healthy 48-year-old man developed Aspergillus keratitis following mild corneal trauma. Intensive medical therapy, initially empirical, then guided by in vitro sensitivity testing, as well as attempts at surgical excision of the infection, were ultimately unsuccessful. The poor therapeutic response may have been due to fungal penetration of the deep corneal stromal before treatment was initiated. The clinical and histologic features of A keratitis are described and related to fungal keratitis in general. The strengths and limitations of laboratory diagnostic aids are discussed. Fungal keratitis may follow a disarmingly mild early clinical course, but requires prompt, aggressive therapy if serious complications are to be avoided.
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PMID:Aspergillus keratitis with intraocular invasion. 703 54

During a nine-year period ending in 1977, we scraped and cultured 663 corneal ulcers. Of these cases of keratitis, 238 were bacterial infections, 133 were fungal, and 292 were culture-negative. Pseudomonas was the predominant bacterial organism, and Fusarium was the most common fungus isolated. November was the peak month for both bacterial and fungal keratitis. Direct inoculation of multiple media, including Sabouraud's agar, blood agar, chocolate agar, thioglycollate liquid, and brain-heart infusion liquid, enhanced the recovery rate; each medium provides special nutrients for different organisms. The Gram and Giemsa stains were satisfactory, but the newer Grocott methenamine silver stain for fungi and the limulus lysate test for gram-negative bacteria proved to be clinically useful. The clinical profile of patients with fungal keratitis differed from that of patients with Pseudomonas keratitis. Thirty-three percent of the patients with Pseudomonas keratitis were wearing contact lenses at the time of their infection, and the remainder had a high incidence of predisposing ocular conditions. Fungal keratitis tended to occur in healthy male patients who had been subjected to outdoor trauma.
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PMID:Spectrum of microbial keratitis in South Florida. 739 57

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

Keratomycosis, a vision-threatening corneal infection, is a challenge to the ophthalmologist because it is often refractory to medical treatment. Surgical keratectomy may not only debulk the major infectious source but potentiate the intracorneal penetration of the antifungal agents. To evaluate the efficacy of keratectomy in managing the fungal corneal ulcer, three common keratomycosis models, Candida, Fusarium, and Aspergillus keratitis, were established in 46 eyes of 23 rabbits (each group had 14, 16 and 16 eyes respectively). Within each keratitis group, the infected eyes were randomly divided into equally numbered experimental and control subgroups. The eyes of the experimental subgroups underwent therapeutic lamellar keratectomy once the typical fungal corneal infection had developed after inoculation. Following keratectomy, eyes of both the treated and control groups received natamycin eyedrops and were regularly examined biomicroscopically. Our results showed that therapeutic lamellar keratectomy is beneficial in chronic, indolent keratitis, such as Candida and Fusarium keratitis, where it promoted corneal healing and shortened the duration of treatment required. The procedure is a valuable adjunctive measure for antifungal agents in these two types of keratitis. However, acute keratitis of the Aspergillus group did not benefit from keratectomy; in these cases, surgery may actually increase the risk of corneal perforation.
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PMID:Therapeutic lamellar keratectomy in the management of experimental keratomycosis. 791 71

Mycotic keratitis, an important ophthalmologic problem, especially in outdoor workers in the tropics, is frequently caused by filamentous fungi such as species of Fusarium, Aspergillus and Curvularia, and by yeast-like fungi such as Candida. A rapid, presumptive diagnosis can be made by recognition of certain typical clinical features and by direct microscopic detection of fungi in corneal scrapings stained by various methods. The diagnosis is confirmed by culture. In difficult cases, microbiological studies on corneal biopsies or histopathological studies on tissue sections may need to be performed. The use of fluorescein-conjugated lectins and similar diagnostic tools is aimed at providing rapid, species-specific detection of fungi in corneal tissue. Antifungal therapy must be instituted as soon as the diagnosis is made. While keratitis due to Aspergillus, Candida and dematiaceous fungi can be successfully treated by many of the currently available polyenes and azoles, the treatment of Fusarium keratitis still frequently requires the use of pimaricin or econazole. Treatment by the oral and parenteral routes may prove useful in severe mycotic keratitis. Surgery may need to be performed on cases unresponsive to medical therapy or where serious complications are likely to occur. The pathogenesis of mycotic keratitis appears to involve agent factors, such as invasiveness and toxigenicity, and host factors, such as trauma and intrinsic defects in resistance. Areas for future research include the development of rapid, species-specific diagnostic aids, of broad-spectrum antifungal compounds active by various routes, and of therapeutic modalities which act on the fungus and on molecules involved in the pathogenesis of the condition.
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PMID:Mycotic keratitis--an underestimated mycosis. 798 69

Keratomycosis is a rare sight-threatening infection of the cornea. Important predisposing factors in its pathogenesis include corneal trauma and use of topical corticosteroid or antibiotic-corticosteroid therapy. Some family physicians are unaware of the dangers of unmonitored topical corticosteroid therapy for traumatised eyes. Three cases of Fusarium keratitis following the use of topical antibiotic-corticosteroid therapy in traumatised eyes are reported. Despite aggressive anti-fungal therapy, one eye required a therapeutic penetrating keratoplasty for impending corneal perforation, another eye progressed to corneal perforation and required evisceration while the third eye developed endophthalmitis which also required evisceration. The potential danger of fungal infections of the cornea following the unmonitored use of topical antibiotic-corticosteroids in traumatised eyes is highlighted.
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PMID:Fusarium keratitis following the use of topical antibiotic-corticosteroid therapy in traumatised eyes. 905 17


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