amphotericin-b and Eye-Injuries

Colletotrichum species are known as important pathogens of plants with an impact on crop production. Some of these species are also known as a cause of rare ophthalmic infections in humans. A case of keratitis caused by Colletotrichum dematium after corneal trauma in a 56-year-old woman is presented. Infection was diagnosed based on positive microscopy and culture. The fungal isolate was identified by morphological characteristics and DNA sequencing of the ITS rDNA region, β-tubulin (tub2) and glyceraldehyde-3-phosphate dehydrogenase (gapdh) genes. The patient responded well to topical therapy with amphotericin B combined with intravenous amphotericin B but improvement was associated with the corneal collagen cross-linking. The review of the literature revealed another 13 cases of C. dematium keratitis, all but one patient having at least one keratitis risk factor in their history. Almost all patients (n = 12) were treated with topical polyene antibiotics (natamycin or amphotericin B), improvement and cure were achieved in eight of them.

Topics: Administration, Topical; Adolescent; Adult; Amphotericin B; Antifungal Agents; Colletotrichum; DNA, Ribosomal Spacer; Eye Injuries; Female; Glyceraldehyde-3-Phosphate Dehydrogenase (Phosphorylating); Humans; Keratitis; Male; Microbiological Techniques; Middle Aged; Molecular Diagnostic Techniques; Mycoses; Sequence Analysis, DNA; Treatment Outcome; Tubulin; Young Adult

Owing to a lack of appropriate diagnostic and therapeutic approaches for mycotic keratitis, approximately one million cases of preventable corneal blindness are reported each year. The number of keratitis cases due to infection with Fusarium is increasing significantly worldwide, many of which are not treated adequately and in a timely manner due to frequent misdiagnosis. In the current report, we describe three cases of keratitis caused by Fusarium solani sensu stricto (FSSC5) from Turkey and The Netherlands, following ocular trauma. The etiological agent of keratitis, FSSC5, identified by sequencing of the partial tef1-α gene, exhibited low minimum inhibitory concentrations (MICs) of 1 µg/mL for amphotericin B and high MICs above the published epidemiological cutoff values for voriconazole (8 µg/mL). Patients were successfully treated with topical amphotericin B and voriconazole with complete recovery.

Topics: Adolescent; Amphotericin B; Antifungal Agents; Eye Infections, Fungal; Eye Injuries; Female; Fungal Proteins; Fusariosis; Fusarium; Humans; Keratitis; Male; Microbial Sensitivity Tests; Middle Aged; Netherlands; Peptide Elongation Factor 1; Sequence Analysis, DNA; Treatment Outcome; Turkey; Voriconazole

To report the first case of fungal keratitis caused by presumed Carpoligna species.. A 37-year-old gardener sustained a full-thickness, stellate corneal laceration while cutting wood outdoors with a circular saw. Two months after surgical repair, he developed a severe infectious keratitis with descemetocoele at the apex of the original stellate laceration.. Culture results confirmed fungal elements without evidence of bacteria. Oral and topical voriconazole were initiated. Due to compliance and cost issues, voriconazole was replaced with natamycin 5% prior to discharge from hospital. The patient improved and healed without perforation. The patient was left with a central stromal scar. DNA extraction from the fungal colony allowed PCR amplification of the 28s ribosomal RNA region of the fungus that led to the diagnosis of Carpoligna pleurothecii. Corticosteroids were never used during the patient's treatment.. This is the first reported case of infectious keratitis caused by presumed Carpoligna species. The treatment for Carpoligna pleurothecii keratitis includes voriconazole, natamycin, and possibly amphotericin B.

Topics: Adult; Amphotericin B; Antifungal Agents; Base Sequence; Corneal Injuries; Corneal Ulcer; DNA, Fungal; Eye Infections, Fungal; Eye Injuries; Humans; Lacerations; Male; Mitosporic Fungi; Molecular Sequence Data; Natamycin; Polymerase Chain Reaction; Pyrimidines; RNA, Fungal; RNA, Ribosomal, 28S; Triazoles; Voriconazole

To describe a patient with Exophiala jeanselmei keratitis. METHODS.. One patient with persistent corneal infiltrate that developed several days after a minor ocular trauma from an onion slice.. Culture plates from corneal scraping showed a growth of the yeast Exophiala jeanselmei, a rare causative agent of ocular infection.. Whenever a corneal abscess does not improve with the usual antibiotic treatment, a thorough ophthalmic history should be taken to determine whether there was a recent ocular trauma. If the trauma was caused by a plant material, the physician should raise the possibility of an unusual fungal infection.

Topics: Amphotericin B; Anti-Infective Agents, Local; Chlorhexidine; Corneal Injuries; Drug Therapy, Combination; Exophiala; Eye Infections, Fungal; Eye Injuries; Female; Humans; Keratitis; Middle Aged; Mycoses; Natamycin; Wounds, Nonpenetrating

Fungal keratitis is a significant cause of ocular morbidity in India. The most commonly implicated fungi are Aspergillus spp. Patients often present with hypopyon, which usually contains fungal elements. The treatment is difficult owing to poor intraocular penetration of most available antifungal agents. This study evaluated the results of intracameral injection of amphotericin B in natamycin resistant cases of severe keratomycosis.. Three patients of culture proven Aspergillus flavus corneal ulcer with hypopyon not responding to topical natamycin 5%, amphotericin B 0.15%, and oral itraconazole were administered intracameral amphotericin B. The first case received 7.5 microg in 0.1 mL followed by two subsequent injections of 10 microg in 0.1 mL each, the second case received two injections of 10 microg in 0.1 mL, and the third patient received a single dose of 10 microg in 0.1 mL. Culture of the aqueous sample also grew A. flavus in all three cases.. All three cases responded favorably, with the ulcer and hypopyon clearing completely. There was no clinical evidence of corneal or lenticular toxicity in any patient.. Intracameral amphotericin B may be a useful modality in the treatment of severe keratomycosis not responding to topical natamycin. It ensures adequate drug delivery into the anterior chamber and may be especially useful to avoid surgical intervention in the acute stage of the disease.

Topics: Adult; Amphotericin B; Anterior Chamber; Antifungal Agents; Aqueous Humor; Aspergillosis; Aspergillus flavus; Corneal Injuries; Corneal Ulcer; Eye Infections, Fungal; Eye Injuries; Humans; Injections; Male; Suppuration

We report a case of scleritis caused by Aspergillus fumigatus. The infection was successfully treated with antifungal drugs, cryotherapy and dura mater grafting. A 67-year-old man developed a scleral ulcer 2 months after suffering a trauma in his right eye caused by the branch of a tree. Diagnosis was made after biopsy of a scleral nodule. Scrapings showed hyphal fragments and cultures were positive for Aspergillus fumigatus. Although therapy with oral fluconazol and topical amphotericin B was begun, the scleritis continued to worsen, so cryotherapy and dura mater grafting were performed. The patient showed no signs of infection for 8 months after discontinuation of antifungal drugs.

Topics: Aged; Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Cryotherapy; Dura Mater; Eye Infections, Fungal; Eye Injuries; Fluconazole; Humans; Male; Scleritis

Topics: Acremonium; Alternaria; Amphotericin B; Aspergillosis; Aspergillus; Candida albicans; Candidiasis; Corneal Ulcer; Drug Resistance, Microbial; Exophiala; Eye Foreign Bodies; Eye Injuries; Fusarium; Humans; Mycoses

Topics: Adult; Amphotericin B; Endophthalmitis; Eye Injuries; Humans; Male; Mycoses

A 49-year-old man developed Aspergillus endophthalmitis after a perforating corneal injury. The infection was successfully treated with antifungal therapy and surgery.

Topics: Amphotericin B; Aspergillosis; Endophthalmitis; Eye Injuries; Flucytosine; Humans; Male; Middle Aged

Topics: Adult; Amphotericin B; Corneal Diseases; Eye Foreign Bodies; Eye Injuries; Humans; Male; Natamycin; Penicillium; Penicillium chrysogenum

Candida albicans was the most common fungus responsible for mycotic keratitis in our series from a northern climate, as opposed to southern climates where other fungi were more common. Pimaricin was effective in our patients with Candida infections and in one patient with Aspergillus infection that had been unresponsive to previous amphotericin B.

Topics: Acetazolamide; Aged; Agricultural Workers' Diseases; Amphotericin B; Aspergillosis; Atropine; Candidiasis; Corneal Ulcer; Cyclopentanes; Dimethylamines; Eye Injuries; Female; Gentamicins; Humans; In Vitro Techniques; Keratitis; Male; Middle Aged; Mycoses; Natamycin; Neomycin; Phenylacetates; Polymyxins; Staphylococcal Infections; Tyrothricin; Wisconsin

A case of Candida endophthalmitis was clinically diagnosed three weeks after perforating injury. It was successfully treated with vitrectomy and intravitreal injection of 5 mcg of amphotericin B. A Candida speices was cultured from the vitreous aspirations.

Topics: Amphotericin B; Candida; Candidiasis; Child; Endophthalmitis; Eye Injuries; Humans; Male; Visual Acuity; Vitreous Body

Topics: Abscess; Administration, Topical; Adult; Amphotericin B; Anti-Bacterial Agents; Anti-Inflammatory Agents; Atropine; Cornea; Ethylmercury Compounds; Eye Diseases; Eye Injuries; Glucocorticoids; Humans; Male; Mitosporic Fungi; Mycoses; Ointments; Ophthalmic Solutions; Phenylephrine

Topics: Administration, Topical; Amphotericin B; Bacitracin; Corneal Injuries; Corneal Ulcer; Eye Injuries; Gentamicins; Humans; Male; Middle Aged; Mitosporic Fungi; Mycoses; Natamycin; Neomycin; Ophthalmic Solutions; Polymyxins; Sulfacetamide; Wound Infection

Topics: Acremonium; Adult; Amphotericin B; Aspergillosis; Candidiasis; Conjunctiva; Cornea; Corneal Transplantation; Corneal Ulcer; Curettage; Eye Diseases; Eye Injuries; Female; Fusarium; Humans; Male; Mycoses; Nystatin; Potassium Iodide

Topics: Abscess; Adrenal Cortex Hormones; Adult; Amphotericin B; Aspergillosis; Aspergillus; Chloramphenicol; Cornea; Corneal Transplantation; Dexamethasone; Eye Diseases; Eye Injuries; Humans; Male; Natamycin; Nystatin; Ophthalmic Solutions; Oxacillin; Sulfacetamide; Transplantation, Homologous

Topics: Amphotericin B; Anti-Bacterial Agents; Atropine; Chloramphenicol; Cornea; Corneal Ulcer; Diabetes Mellitus; Eye Injuries; Fusarium; Glaucoma; Humans; Mycoses; Ointments; Ophthalmic Solutions; Ophthalmology; Penicillins; Streptomycin; Toxicology; Ulcer