A Study of Fungal Keratitis in North Africa: Exploring Risk Factors and Microbiological Features

Mehta, R. K.; Mehta, Pratibha; Rao, Mana; Acharya, Yogesh; A, Sireesha Bala; J, Krishna Sowmya

doi:10.21276/ijlssr.2016.2.5.11

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…Few studies stated that risks for developing deep stromal fungal keratitis include persons with diabetes 6 . Diabetes was identified as a common risk factor with 17.8% of patient has a history of diabetes mellitus 13 . Diabetes in the present case seems to have predisposed to this rare yeast infection as in the post LASIK case 6 …”

Section: Discussionmentioning

confidence: 64%

Fungal keratitis caused by a rare ocular pathogen, Gjaerumia minor : A case report

Al‐Falki

Al-Shehri

Joseph

et al. 2018

Saudi Journal of Ophthalmology

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Fungal keratitis is an important infection of the eye that may cause devastating effects. Keratitis caused by fungi has been described in many parts of the world mainly in tropical countries. The objective of this study is to report a serious eye infection in an adult with a known history of diabetes caused by an uncommon yeast fungus with details of clinical findings and laboratory investigations. Left eye visual acuity was no perception of light due to end stage neovascular glaucoma. The patient was pseudophakic in both eyes. Culture of a corneal scraping showed yeast like organism on Sabouraud dextrose agar. a rare yeast but with history of a pulmonary infection in the region, was confirmed with 98% similarity in the large subunit ribosomal RNA gene (accession KY690175). Topical Amphotericin B and oral fluconazole were initiated. The patient showed gradual improvement, epithelial defect healed, infiltration steadily regressed and hypopyon disappeared. We report the first case of fungal keratitis caused by in Saudi Arabia. Fungal Keratitis should be considered in cases where clinical response to the conventional antibacterial antibiotic treatment is not optimal.

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Section: Discussionmentioning

confidence: 64%

Fungal keratitis caused by a rare ocular pathogen, Gjaerumia minor : A case report

Al‐Falki

Al-Shehri

Joseph

et al. 2018

Saudi Journal of Ophthalmology

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“…Diabetes mellitus has also been identified as a predisposing factor in some patients. [3] Often, fungal keratitis has worse clinical results than bacterial keratitis. Studies have highlighted the advantage of topical natamycin for fungal keratitis over topical voriconazole, especially among those caused by Fusarium.…”

Section: Discussionmentioning

confidence: 99%

“…[1] In developed countries (North America, West Europe, and Australia), a high proportion of bacterial ulcers has been identified, and the highest proportion of corneal infections in Libya is related to fungi. [3] A major cause of microbial keratitis is fungal keratitis. [2] An increase in its occurrence has been conveyed in recent years, but in terms of diagnosis and treatment, the disease is still a challenge.…”

Section: Introductionmentioning

confidence: 99%

“…Aspergillus has the worst prognosis in general, but it shows a positive response to antifungal drugs. [3,8] Medical suspicion is the main factor in the diagnosis of mycotic keratitis. [9] The clinical presumption of a microbial keratitis agent may be based on clinical and epidemiological evidence, and clinical suspicion may be useful in directing antimicrobial therapy and early therapy.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of fungal keratitis in Libya: An epidemiological study

Atia

Ashour

Alfaigh³

2021

AUJMSR

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Objectives: The aim of this study was to assess the occurrence of eye fungal infection among patients attending the eye hospital in Tripoli city, Libya. Materials and Methods: Seventy-one patients with ocular fungal infections were subjected to clinical and microbiological investigations. They were selected from patients attending the Tripoli Eye Hospital. The specimens of the external ocular infections were collected using sterile swab and inoculated to different culture media. Data were presented as count and percentages. Results: The current findings showed that Aspergillus was the most common causative agent, being responsible for 91.54% of the all cases, followed by Candida albicans (8.46%). Conclusion: Occurrence of fungal keratitis gradually increased in the years after 2009, especially after 2013. Knowledge of the pathological course and clinical features of fungal keratitis will undoubtedly bead in early diagnosis and treatment, with reduction in ocular morbidity.

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Mycotic Keratitis—A Global Threat from the Filamentous Fungi

Hoffman

Burton

Leck

2021

JoF

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Mycotic or fungal keratitis (FK) is a sight-threatening disease, caused by infection of the cornea by filamentous fungi or yeasts. In tropical, low and middle-income countries, it accounts for the majority of cases of microbial keratitis (MK). Filamentous fungi, in particular Fusarium spp., the aspergilli and dematiaceous fungi, are responsible for the greatest burden of disease. The predominant risk factor for filamentous fungal keratitis is trauma, typically with organic, plant-based material. In developed countries, contact lens wear and related products are frequently implicated as risk factors, and have been linked to global outbreaks of Fusarium keratitis in the recent past. In 2020, the incidence of FK was estimated to be over 1 million cases per year, and there is significant geographical variation; accounting for less than 1% of cases of MK in some European countries to over 80% in parts of south and south-east Asia. The proportion of MK cases is inversely correlated to distance from the equator and there is emerging evidence that the incidence of FK may be increasing. Diagnosing FK is challenging; accurate diagnosis relies on reliable microscopy and culture, aided by adjunctive tools such as in vivo confocal microscopy or PCR. Unfortunately, these facilities are infrequently available in areas most in need. Current topical antifungals are not very effective; infections can progress despite prompt treatment. Antifungal drops are often unavailable. When available, natamycin is usually first-line treatment. However, infections may progress to perforation in ~25% of cases. Future work needs to be directed at addressing these challenges and unmet needs. This review discusses the epidemiology, clinical features, diagnosis, management and aetiology of FK.

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A Study of Fungal Keratitis in North Africa: Exploring Risk Factors and Microbiological Features

Cited by 4 publications

References 11 publications

Fungal keratitis caused by a rare ocular pathogen, Gjaerumia minor : A case report

Fungal keratitis caused by a rare ocular pathogen, Gjaerumia minor : A case report

Incidence of fungal keratitis in Libya: An epidemiological study

Mycotic Keratitis—A Global Threat from the Filamentous Fungi

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