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)

Fluconazole, an experimental azole antifungal agent with good tissue penetration following oral administration, offers the possibility of a new approach to the treatment of keratomycosis. Its efficacy as an orally administered agent was investigated in two models of experimental fungal infection in Dutch-belted rabbits. The study proceeded in three stages. In the first, a model of keratitis due to Aspergillus fumigatus was developed, the suitability of quantitative isolate recovery techniques for the evaluation of the disease caused by this organism was confirmed, and the correlation between the severity of clinical disease scored nonparametrically and the isolate recovery rate was established. The model was found to be most useful for study during the first 5 days of infection. The natural course of experimental Candida alibcans keratitis was evaluated and, on the basis of quantitative isolate recovery techniques, this model was found to be appropriate for studies lasting up to 1 week. In the second stage, corneal uptake following oral administration of fluconazole was studied in Dutch-belted rabbits. The drug was found to readily penetrate the cornea in amounts that correlated with serum levels (R = 0.89). Eight hours following a single 20 mg/kg dose, the corneal level was 7.4 mg/gm, almost double the amount when a 10 mg/kg dose was administered. When given in a twice daily divided dose, fluconazole accumulated steadily in the corneas over a period of 5 days. The presence of inflammation induced by fungal infection did not influence corneal uptake. In the final stage, the efficacy of orally administered fluconazole in the treatment of keratomycosis was evaluated. Overall, a significant therapeutic effect was observed with both infections. Treatment of the animals with oral fluconazole for 1 day prior to inoculation with Candida albicans led to a significant decrease in isolate recovery 1 day later (P = 0.01). However, when treatment was continued for 5 days following inoculation, no additive effect of pretreatment was noted. Pretreatment for 1 day followed by 5 days postinoculation treatment led to a significant decrease in clinical disease (P less than 0.05) and isolate recovery (P = 0.05). A beneficial effect of pretreatment compared to treatment begun 1 day postinoculation, as measured by a reduction in clinical severity and isolate recovery, was also noted. On the basis of these short-term therapeutic studies and the excellent corneal penetration of fluconazole, further investigation of oral therapy of keratomycosis appears warranted.
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PMID:Orally administered antifungal therapy for experimental keratomycosis. 209 36

A 12-year-old girl with fungal keratitis following injury with a vegetable foreign body was successfully treated with oral fluconazole, a new antifungal agent. The infection resolved completely with good visual recovery. Fluconazole was well tolerated systemically.
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PMID:Oral fluconazole therapy for keratomycosis. 774 92

BACKGROUND Pythium insidiosum keratitis is a rare but sight-threatening disease with a high morbidity rate. It can be misdiagnosed as fungal keratitis in clinic settings. We report a case of severe Pythium insidiosum keratitis in a Chinese child, treated with combined approaches. CASE REPORT A 7-year-old boy from Hainan province in the south of China developed a suppurative corneal ulcer after being in a forest. A mass of hyphae was detected by confocal imaging in vivo, fungal smear test, and histochemical examination. Treatment with Natamycin, fluconazole, and Voriconazole for 1 month was unsuccessful, and a penetrating keratoplasty with anterior vitrectomy was performed. The infection reappeared 1 day after surgery, immediately after which anterior chamber irrigation with 0.02% Fluconazole and amphotericin B solution was performed. Finally, the globe was saved and there was no further recurrent infection. A cultured mycelial organism, which was hard to identify by biomorphology, was confirmed by PCR to be Pythium insidiosum. The zoospores were observed in water environments. The imaging characteristics of P. insidiosum in confocal microscopy are described herein. CONCLUSIONS This is the first case of Pythium insidiosum keratitis reported in China. It can be misdiagnosed as fungal keratitis in the clinic. Improving the awareness of clinicians, promoting early diagnosis, and a multidisciplinary approach, especially early surgery, improve the prognosis.
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PMID:Diagnosis and Treatment of Pythium Insidiosum Corneal Ulcer in a Chinese Child: A Case Report and Literature Review. 2802 73

Keratitis due to Candida parapsilosis or Corynebacterium macginleyi is uncommon. We present a patient with several risk factors who suffered two subsequent corneal infections caused by these pathogens and healed with topical conservative therapy. The important factor was the early detection of infection. Fluconazole solution administered topically as eye drops combined with regular debridement proved in this case a successful alternative to systemic antifungal treatment. With a perceived recurrence of the keratitis, one must take into account the involvement of other pathogens present. The previous use of an antifungal solution other than a conventional eye drop could be an additional risk factor for a second bacterial infection, but the benefits should still rule in favor of such a treatment.
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PMID:Keratitis Caused by Candida parapsilosis and Subsequent Corynebacterium macginleyi Infection: Case Report and Short Review. 3257 53