A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species

Jin, Ki Won; Jeon, Hyun Sun; Hyon, Joon Young; Wee, Won Rynag; Suh, Wool; Shin, Young Joo

doi:10.1186/1471-2415-14-90

Cited by 10 publications

(9 citation statements)

References 10 publications

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“…Direct microscopic examination, fungal culture, and analysis of physiological characteristics were the main methods of identification. In 2001, Tang et al reported a case of keratitis with left eyelids infection caused by T. mentagrophytes [20], And in 2014, Jin KW et al reported a case of keratomycosis with onychomycosis [32]. In addition to these two cases, other literature reports were no co-existence of skin or nails infections, or the history is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…(14)–Direct smear + cultureUnclear[21]2014Delhi, India T. rubrum (1); T. erinacei (1)TraumaCulture + biochemical identificationNo[26]2014Korea Trichophyton spp. (1)–Smear + cultureOnychomycosis[32]2018Changchun, China T. interdigitale (1)–Smear + culture + ITS sequencingDermatophytosisPresent study…”

Section: Discussionmentioning

confidence: 99%

“…Although the former two have no horny layer, they can express keratin, and all three structures can be infected by Trichophyton species. Through the secretion of an extracellular collagenase with keratinolytic potential, Trichophyton species can cause severe stromalysis, leading to loss of vision [32]. Any breach of the corneal epithelial cell layer facilitates the penetration of fungi into the stroma.…”

Section: Discussionmentioning

confidence: 99%

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Simultaneous dermatophytosis and keratomycosis caused by Trichophyton interdigitale infection: a case report and literature review

Zhang

Jiang

et al. 2019

BMC Infect Dis

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BackgroundDermatophytosis is a fungal infectious disease caused by dermatophytes, which produce protease and keratinase to digest keratin, leading to the colonization, invasion, and infection of the stratum corneum of the skin, hair shafts, and nails. Trichophyton interdigitale belongs to Trichophyton mentagrophytes complex, which is the common pathogen causing dermatophytosis. Fungal keratitis, also called keratomycosis, is an infectious disease of cornea.Case presentationHere, we report a case of simultaneous dermatophytosis and keratomycosis caused by Trichophyton interdigitale. A 67-year-old man presented with extensive erythema all over the body since 4 years ago, fungal infection of left eye for 2 years, and loss of vision in the eye. These symptoms had become aggravated in the last month. Dermatological examinations showed extensive erythematous plaques with clear borders and scales, scattered red papules with ulceration, and scabs throughout the body. Onychomycosis was observed on the nails of left hand, conjunctival infection with secretion and loss of vision were noted in left eye. Hyaline septate hyphae were observed under direct microscopic examination, fungal culture and internal transcribed spacer sequencing revealed T. interdigitale. Histopathological examination suggested infectious granuloma. A diagnosis of dermatophytosis and keratomycosis caused by T. interdigitale with loss of vision in left eye was made. The patient was treated with luliconazole cream (two applications per day) and itraconazole (100 mg, BID, PO). Complete clinical remission was achieved after 1 month. Subsequently, the patient underwent left eye enucleation in the ophthalmology department.ConclusionsIn the present study, we reported a case of simultaneous dermatophytosis and keratomycosis caused by T. interdigitale, and reviewed the literature on corneal infection caused by Trichophyton. A total of 10 articles with 45 patients were published between 1973 and 2018. The pathogen of 27 patient were identified to species level. There were T. schoenleinii (17), T. mentagrophytes (4), T. verrucosum (3), T. rubrum (1), T. erinacei (1), and T. interdigitale (1). Five patients had corneal trauma, one had contact lens use history. Direct microscopic examination, fungal culture, and analysis of physiological characteristics were the main methods of identification. Early diagnosis and prompt treatment may help improve the management and outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Simultaneous dermatophytosis and keratomycosis caused by Trichophyton interdigitale infection: a case report and literature review

Zhang

Jiang

et al. 2019

BMC Infect Dis

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“…The common risk factors for fungal keratitis are trauma with vegetative matter or objects contaminated with soil, contact lenses, ocular surface disease, lacrimal duct occlusion, fungal skin infections, long-term use of antibiotics or steroids locally or systemically [2,[13][14][15][16][17]. Other relatively rare risk factors include history of eye surgery, herpes simplex virus keratitis, eyelid abnormalities, etc.…”

Section: Risk Factorsmentioning

confidence: 99%

Fungal Keratitis: Recent Advances in Diagnosis and Treatment

Suman¹,

Kumar²,

Saxena³

et al. 2021

Infectious Eye Diseases - Recent Advances in Diagnosis and Treatment

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Fungal keratitis or fungal corneal ulcer is potentially blinding infection of cornea, is considered one of the major cause of ocular morbidity, particularly in developing countries. It is a common cause of infectious keratitis, especially in tropical and subtropical countries. Fungal keratitis is notoriously challenging to diagnosis and difficult to treat. Delay in diagnosis may result in irreversible sequelae of corneal fungal infections, which can be preventable. Fungal keratitis often have worse treatment outcomes than bacterial keratitis, Delayed diagnosis and scarcity of effective antifungal agents are the major factors for poor outcome. In the recent years considerable advancement in the diagnosis and treatment has been occurred. In this chapter, we will discuss the recent advances in diagnosis and management of fungal keratitis with a brief discussion on pathogenesis and future therapeutic models.

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“…[81,82,83]. In addition, in treatments with prophylactic and therapeutic purposes for confections, fortified or coadministered agents are used that may affect the efficacy of the other agent [84,85].…”

Section: Based On Mics With Microdilutions and The Growth Radial Techmentioning

confidence: 99%

Eye Coinfections

Pantoja-Meléndez¹,

Lucio²,

Ortiz-Casas³

et al. 2016

Advances in Common Eye Infections

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Ocular infections are an ophthalmologic emergency that threatens the eye's integrity, which may result in a poor visual outcome; hence, it requires prompt treatment. The most common microorganisms involved in eye infection are the bacteria, followed by virus and fungi; however the prevalence depends on the geographic location. It is essential to know The etiologic agent of the ocular infection ocular infections and their antibiotic sensitivity because the geographical situation and the urbanization level of the studied population will determine their prevalence. Recently have been described eye coinfections, where at least two microorganisms can infect at the same time and the same anatomic site. Several coinfections have been published, bacteria-bacteria, bacteria-fungus, bacteria-virus, fungus-yeast, fungus-virus, parasite-bacteria, etc. Eye coinfections represent a particular challenge for the ophthalmologists; coinfections are difficult to diagnose because often the clinical characteristic is atypical and mimics different clinical pictures. In addition, eye coinfections respond poorly to antibiotics and usually present an aggressive clinical course. In these circumstances, it is common for patients to receive multiple treatments when they should be receiving a specific treatment. Several risk factors are important to develop coinfections, e.g., trauma, dry eye, use of contact lenses, and comorbidities (diabetes and immunosuppression). Coinfections have been described in keratitis, conjunctivitis, and endophthalmitis. The study of polymicrobial biofilms has been increasing, and in the medical area, the role played by biofilms in confections has been associated with virulence factors; hence, biofilm formation is also considered a determinant virulence factor for pathogenesis in the host. Coinfection diagnosis is an important topic in order to obtain a specific and timely diagnosis. Microbiological and molecular approaches are proposed to identify etiological agents. Delay in diagnosis affects the sensitivity to specific treatments and the evolution of infection. Treatment and prognosis are supported by a specific diagnosis.

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A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species

Cited by 10 publications

References 10 publications

Simultaneous dermatophytosis and keratomycosis caused by Trichophyton interdigitale infection: a case report and literature review

Simultaneous dermatophytosis and keratomycosis caused by Trichophyton interdigitale infection: a case report and literature review

Fungal Keratitis: Recent Advances in Diagnosis and Treatment

Eye Coinfections

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