1/135. exophiala (Wangiella) dermatitidis keratitis after keratoplasty.We report the first French case of an intraocular infection due to exophiala (Wangiella) dermatitidis. Two months after a second corneal transplant for congenital hereditary endothelial dystrophy, the patient presented with ocular pain and corneal infiltrates leading to the graft rejection. Diagnosis was established by positive direct examination and cultures of the same fungus from corneal buttons, iris biopsies and ablated sutures.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
2/135. Mycotic keratitis in non-steroid exposed vernal keratoconjunctivitis.PURPOSE: To report a patient with vernal keratoconjunctivitis who developed mycotic keratitis in absence of known risk factors. methods: A 17-year-old male suffering from vernal keratoconjunctivitis presented with infective keratitis. The patient had been treated in the past with topical antihistaminics and vasoconstrictors. The patient had not been exposed to topical steroids in 2 years of follow-up. He did not have dry eye or corneal micro or macroerosions prior to the development of infective keratitis. Corneal scrapings were obtained and subjected to KOH wet mount smear, calcofluor and Grams stain as well as bacterial culture sensitivity and fungal culture. RESULTS: Clinical diagnosis of mycotic keratitis in association with vernal conjunctivitis was supported by microbiological investigations. KOH wet mount and calcofluor staining showed presence of filamentous septate hyphae while fungal culture showed growth of aspergillus fumigatus. Antifungal therapy was initiated in the form of topical natamycin 5% suspension to which the patient responded and recovered 6/6 final visual acuity. CONCLUSION: The authors wish to conclude that patients suffering from vernal keratoconjunctivitis, even in the absence of corneal involvement, steroid exposure and trauma, may be at increased risk of developing keratomycosis.- - - - - - - - - - ranking = 2keywords = keratitis (Clic here for more details about this article) |
3/135. Exserohilum rostratum causing keratitis in india.A case of mycotic keratitis due to atypical Exserohilum rostratum is reported in a 42-year-old male with Hansens disease.- - - - - - - - - - ranking = 1.25keywords = keratitis (Clic here for more details about this article) |
4/135. chrysosporium parvum keratomycosis.PURPOSE: To report a case of corneal infection with chrysosporium parvum, a filamentous fungus usually associated with pulmonary infections. methods: A 43-year-old Saudi man had a corneal stromal infiltrate and perforation of his left eye. He was treated with a therapeutic penetrating keratoplasty and topical and systemic antifungal therapy. Corneal scrapings, microbiologic evaluation, and histopathologic examination of the surgical specimen were performed to establish the diagnosis. After the development of recurrent stromal keratitis at the graft-host junction, similar diagnostic and therapeutic maneuvers were performed. RESULTS: Corneal scrapings and histopathologic examination were positive for numerous septate hyphae with endospores, consistent with a diagnosis of filamentous keratomycosis. Microbiologic isolation confirmed the diagnosis of chrysosporium parvum. Similar diagnostic maneuvers for recurrent keratitis produced identical results. CONCLUSION: To our knowledge, this is the first case of chrysosporium parvum keratomycosis.- - - - - - - - - - ranking = 0.5keywords = keratitis (Clic here for more details about this article) |
5/135. Mycotic keratitis due to Curvularia senegalensis and in vitro antifungal susceptibilities of Curvularia spp.A case of mycotic keratitis due to Curvularia senegalensis is reported. This case represents the third known reported infection caused by this rare species. Fungal hyphae were detected in corneal scrapings, and repeated cultures were positive for this fungi. The patient was presumed cured after a corneal transplant and treatment with itraconazole, but the infection recurred and the patient is waiting for a keratoplasty. The in vitro antifungal susceptibilities of the case strain and another 24 strains belonging to seven species of Curvularia were tested for six antifungal agents. With the exception of flucytosine, and occasionally fluconazole, the other drugs assayed (amphotericin b, miconazole, itraconazole, and ketoconazole) were highly effective in vitro.- - - - - - - - - - ranking = 1.25keywords = keratitis (Clic here for more details about this article) |
6/135. Treatment of acanthamoeba keratitis combined with fungal infection with polyhexamethylene biguanide.From July 1996 to March 1997, three cases of acanthamoeba keratitis combined with fungal infection were diagnosed and treated at our ophthalmic department. Specimens from all of these cases were obtained by corneal scraping, keratectomy and anterior chamber paracentesis. The diagnosis was confirmed by either the results of smear test or pathology reports. All of these patients received aggressive treatment with polyhexamethylene biguanide (PHMB) 0.02%, fluconazole, and anegyn eye drops. After the infection had been controlled without extension, therapeutic penetrating keratoplasty was performed on all of these patients despite the existence of infiltration beyond the edge of the graft. Postoperatively, eye drops were tapered gradually, and treatment was continued for 1 to 2 months. All three cases achieved good results and there was no recurrence of infection. Two cases had visual acuity of 20/100 and 20/20, while the other one perceived hand movement only due to later graft rejection. These cases suggest that early diagnosis and immediate use of PHMB and anti-fungal agents are effective in the treatment of acanthamoeba keratitis combined with fungal infection.- - - - - - - - - - ranking = 1.5keywords = keratitis (Clic here for more details about this article) |
7/135. Traumatic acremonium atrogriseum keratitis following laser-assisted in situ keratomileusis.A 52-year-old man underwent bilateral laser-assisted in situ keratomileusis. Eight months later, he sustained a penetrating corneal injury to the left eye. A dense white infiltrate, unresponsive to antimicrobial therapy, developed in the corneal stroma. Corneal biopsy and eventual penetrating keratoplasty were performed, and both specimens demonstrated fungal elements with branching, septate hyphae. culture identified the organism as acremonium atrogriseum. Histopathologic features of this organism and its differentiation from other, more common fungal organisms are discussed herein.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
8/135. acremonium keratitis in a patient with herpetic neurotrophic corneal disease.fungi belonging to the genus acremonium Link ex Fries 1821 are ubiquitous environmental contaminants and soil saprophytes, but are infrequent pathogens in humans. These filamentous fungi (previously known as Cephalosporium) are an uncommon cause of mycotic keratitis. As in the case of other filamentous fungi, corneal trauma with contaminated matter is the most frequent risk factor for the infection. We report in this paper a case of keratomycosis caused by Acremoniumpotronii, in a patient with a history of herpetic keratitis. Medical treatment with amphotericin b was unsuccessful and the infection eventually resolved with penetrating keratoplasty.- - - - - - - - - - ranking = 1.5keywords = keratitis (Clic here for more details about this article) |
9/135. Fungal keratitis after laser in situ keratomileusis: a case report.PURPOSE: To report a case of fungal keratitis resulting after laser in situ keratomileusis (LASIK). methods: A 38-year-old white man in good health developed a corneal infiltrate with laboratory confirmation of fungal keratitis after LASIK. Corneal scrapings were taken. silver stain was positive for hyphae. culture was positive for Curvularia sp. The patient was started on intensive natamycin 5% and amphotericin 0.15% topical therapy. RESULTS: The patient's keratitis was successfully treated with intensive antifungal therapy. CONCLUSIONS: Infectious keratitis is a rare but a serious potential complication after LASIK. To our knowledge, no previous case of fungal keratitis after LASIK has been reported. This case emphasizes the importance of surveillance for infection after LASIK.- - - - - - - - - - ranking = 2.25keywords = keratitis (Clic here for more details about this article) |
10/135. Small, overlapping tectonic keratoplasty involving graft-host junction of penetrating keratoplasty.PURPOSE: To report the indications for and postoperative course of small tectonic keratoplasties overlapping (and involving) the graft-host junction of preexisting penetrating keratoplasties. methods: A retrospective study of 15 consecutive eyes (15 patients) with small tectonic keratoplasties overlapping the graft-host junction of preexisting penetrating keratoplasties. RESULTS: After tectonic keratoplasty, follow-up times ranged from 5 months to 20 years (mean, 69 months). Clinical indications included sterile corneal ulceration (seven cases), bacterial keratitis (six cases), and fungal keratitis (two cases). In the six cases with bacterial keratitis, five were suture abscesses, with four resulting in wound dehiscence. Ten tectonic grafts were lamellar keratoplasties, and five were penetrating keratoplasties. Postoperative best-corrected visual acuities were unchanged from preoperative levels in every patient. After tectonic grafting, the mean /- SD change in keratometric astigmatism in the parent penetrating keratoplasty was 1.75 /- 1.50 diopters. The astigmatism increased in 10 cases, decreased in three, and remained unchanged in two. There was no case of recurrent ulceration or wound dehiscence in or around the tectonic grafts. The surgery did not result in new glaucoma or worsening of preexisting glaucoma. CONCLUSIONS: In the treatment of infectious or ulcerative foci at or near the graft-host junction of penetrating keratoplasties, a small extirpative, tectonic graft over the diseased junction appears to be a safe and effective alternative to either repeating the original penetrating keratoplasty or performing an oversize transplant.- - - - - - - - - - ranking = 0.75keywords = keratitis (Clic here for more details about this article) |
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