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

A total of 1010 clinically suspected cases of mycotic keratitis were studied from 1988 to 1996 for evidence of fungal infection and for identification of the aetiologic agents of keratitis in Mumbai. Of these 367 cases were reported positive by microscopy and culture. Seventy nine percent of the cases were between the ages 21 and 50 years. Male patients were more often affected than females. Eighty eight percent of patients were farmers or construction workers and 89.92% of cases gave a definite history of antecedent corneal trauma. A single fungal isolate was obtained in 307 cases and multiple isolates in 20 cases. Mixed isolates of bacteria and fungi were grown in 40 cases. The predominant isolate was Aspergillus species in 219 cases, followed by Candida species (36), Fusarium species (33) and Penicillium species (34). Filamentous fungal isolates from 22 cases remained unidentified. Mycotic keratitis should be suspected in every patient with a corneal lesion and should be ruled out before commencing steroids and antiboitics.
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PMID:A study of mycotic keratitis in Mumbai. 1042 Jun 89

Mycotic keratitis, being frequently refractive to most of the currently available antifungal therapy, continues to pose a therapeutic challenge to the clinician. In keratitis of infectious etiology stromal dissolution may be brought about by a combination of agent and host factors. An understanding of the source and nature of corneal tissue damage is essential for evolving more effective therapeutic modalities in the treatment of fungal keratitis. In the present study, we have characterized the extracellular proteases produced in vitro by corneal fungal pathogens namely the Aspergillus flavus and Fusarium solani when collagen was provided as the sole nitrogen source. In addition, fungal infected rabbit corneas were investigated for proteolytic activities and nature of inflammatory reaction. Gelatin zymography detected protease bands with molecular mass ranging from 100 to 200 kDa in the culture extracts of A. flavus, and a single major band of molecular mass approximately 200 kDa in the culture extracts of F. solani. A basal proteolytic activity of mass 65 kDa was visualized in all uninfected and infected rabbit corneal extracts. Infected corneas in addition revealed the presence of additional proteolytic species of mass 92 and 200 kDa. The enzyme inhibitory profile suggested that fungal cultures in vitro contained predominantly serine protease activity and to a lesser extent metalloprotease activity. However, fungal infected corneal homogenates showed the presence of metalloproteinase activity alone, the enzymatic activities entirely being sensitive to ethylene diamine tetra acetate (EDTA), a metalloprotease inhibitor. Interestingly, the serine proteolytic activity detected in fungal cultures in vitro was not present in the fungal infected corneas in vivo. However, the possible role of fungal serine proteases in the activation of corneal matrix metalloproteinases (MMPs) cannot be ruled out. Based on the criteria of molecular mass, proteolytic activity in the presence of calcium at neutral pH, and sensitivity to inhibition by a metalloprotease inhibitor, the 65 and 92 kDa gelatinases were identified as MMP 2 and MMP 9, respectively. The expression of 92 and 200 kDa gelatinases correlated positively with the amount of polymorphonuclear cells present in the infected tissues. Activated resident corneal cells or inflammatory cells may largely contribute to the increased proteolytic activities in fungal infected corneas resulting in tissue matrix degradation in fungal keratitis.
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PMID:Enzymatic, clinical and histologic evaluation of corneal tissues in experimental fungal keratitis in rabbits. 1127 71

Fungal keratitis following laser in situ keratomileusis (LASIK) is extremely rare. Except in cases that follow trauma, the source of fungal organisms is unknown in published reports. We report a case of keratitis following LASIK that could be directly traced to a fungal skin infection of the patient's pet cat.
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PMID:Curvularia keratitis after laser in situ keratomileusis from a feline source. 1278 Dec 93

Mycotic keratitis usually occurs in conjunction with trauma to the cornea. Scedosporium apiospermum, a dematiaceous fungus linked to the teleomorph Pseudallescheria boydii is not a common agent of mycotic keratitis. A 22-year old male patient with mycotic keratitis due to S. apiospermum is presented. In in vitro susceptibility testing, the isolate showed resistance against amphotericin B (minimum inhibitory concentration [MIC] 16 microg ml(-1)) but was susceptible to itraconazole (ITC) and fluconazole with MICs of 0.125 microg ml(-1) and 4 microg ml(-1), respectively. The patient was cured clinically after ITC treatment and surgical intervention. Azoles may be superior for eliminating S. apiospermum from infected ocular sites.
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PMID:Scedosporium apiospermum keratitis treated with itraconazole. 1296 42

Keratomycosis is a rare sight-threatening infection of the cornea, with greater morbidity than bacterial keratitis. Predisposing factors in its pathogenesis are corneal trauma, mostly of plant origin, and overuse of topical corticosteroids, associated or not with antibiotics. We report a case of a 71-year-old man who developed Fusarium (lichenicola or solani) keratitis, 15 days after beginning topical therapy with a corticosteroid and antibiotic. Despite aggressive antifungal therapy with fluconazole, he required a penetrating keratoplasty for impending corneal perforation, and finally, even after systemic use of itraconazole and topical use of amphotericin B, the infection progressed and an evisceration was required. In the evisceration material, a multidrug-resistant Fusarium lichenicola or solani, was found, partially sensitive to voriconazole only.
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PMID:[Anterior segment necrosis in multidrug-resistant Fusarium keratomycosis: a case study]. 1597 16

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.
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PMID:In vitro and in vivo antifungal activity of cetrimide (cetyltrimethyl ammonium bromide) against fungal keratitis caused by Fusarium solani. 1730 51

The prognosis of fungal and acanthamoeba keratitis depends on early diagnosis and treatment. Keratomycosis treatment requires antifungal eye drops such as polyene, triazoles, or echinocandins, whereas acanthamoeba keratitis therapy is based on biguanide and diamidine agents. The aim of this paper is to review the antifungal and antiamoebicide eye drops that are currently available in ophthalmology.
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PMID:[How to prescribe local antifungal and antiamoebicide topical drugs]. 1748 41

Fungal keratitis is the most common and severe infectious corneal diseases in many developing countries. The disease has become the leading cause of corneal blindness in China. It is imperative to study deeply on pathogenesis of fungal keratitis for lowering its incidence, increasing therapeutic option and enhancing therapeutic efficacy. This article reviewed the advances of related factors in pathogenesis of fungal keratitis including fungal virulence factors and host defense mechanisms.
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PMID:[Advance in pathogenesis of fungal keratitis]. 1760 43

Fungal keratitis is commonly caused by Fusarium species and less commonly by Candida species. Recent outbreaks of Fusarium keratitis were associated with contact lens wear and with ReNu with MoistureLoc contact lens care solution, and biofilm formation on contact lens/lens cases was proposed to play a role in this outbreak. However, no in vitro model for contact lens-associated fungal biofilm has been developed. In this study, we developed and characterized in vitro models of biofilm formation on various soft contact lenses using three species of Fusarium and Candida albicans. The contact lenses tested were etafilcon A, galyfilcon A, lotrafilcon A, balafilcon A, alphafilcon A, and polymacon. Our results showed that clinical isolates of Fusarium and C. albicans formed biofilms on all types of lenses tested and that the biofilm architecture varied with the lens type. Moreover, differences in hyphal content and architecture were found between the biofilms formed by these fungi. We also found that two recently isolated keratitis-associated fusaria formed robust biofilms, while the reference ATCC 36031 strain (recommended by the International Organization for Standardization guidelines for testing of disinfectants) failed to form biofilm. Furthermore, using the developed in vitro biofilm model, we showed that phylogenetically diverse planktonic fusaria and Candida were susceptible to MoistureLoc and MultiPlus. However, Fusarium biofilms exhibited reduced susceptibility against these solutions in a species- and time-dependent manner. This in vitro model should provide a better understanding of the biology and pathogenesis of lens-related fungal keratitis.
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PMID:Fusarium and Candida albicans biofilms on soft contact lenses: model development, influence of lens type, and susceptibility to lens care solutions. 1799 66


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