Etiological agents of fungal endophthalmitis: diagnosis and management

Vilela, Rubens C.; Vilela, Luiza; Vilela, Priscila; Vilela, Raquel; Motta, Rodrigo Patto Sá; Pôssa, Ana Paula; Almeida, Cirênio de; Mendoza, Leonel

doi:10.1007/s10792-013-9854-z

Cited by 28 publications

(43 citation statements)

References 131 publications

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“…Amphotericin B and the azole antifungals are the most commonly used antifungal drugs for treatment of Aspergillus endophthalmitis (8), with voriconazole being the most preferred because it can be delivered by oral, intravenous (i.v. ), and intravitreal (IVT) routes (4) and reaches higher concentrations in the vitreous humor (12). However, the emergence of azole resistance among Aspergillus species (13)(14)(15)) and voriconazole's interaction with other drugs, requiring close therapeutic monitoring (16), warrant evaluation of newer antifungal agents with fewer complications and better therapeutic efficacy for the management of fungal endophthalmitis.…”

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confidence: 99%

Isavuconazole for Treatment of Experimental Fungal Endophthalmitis Caused by Aspergillus fumigatus

Guest

Singh

Revankar

et al. 2018

Antimicrob Agents Chemother

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Fungal endophthalmitis remains a significant cause of vision impairment and blindness. Moreover, the prognosis is poor, in part due to delay in diagnosis and to limited availability of effective antifungal agents with good ocular penetration. Thus, it is imperative to evaluate the therapeutic efficacy in fungal endophthalmitis of newer antifungal agents. In this study, we assessed the efficacy of isavuconazole in treating endophthalmitis in an exogenous mouse model of the disease. Briefly, endophthalmitis was induced by intravitreal (IVT) injection of spores into immunocompetent C57BL/6 (B6) mouse eyes. Mice were randomized into five groups that received isavuconazole via (i) oral gavage, (ii) IVT injections, (iii) intravenous injection, (iv) IVT injection followed by oral gavage, and (v) IVT injection followed by intravenous injection. Our data showed that isavuconazole treatment via all routes reduced fungal burden in -infected eyes. This coincided with the preservation of retinal structural integrity (histology analysis) and retinal function (electroretinography [ERG] analysis), resulting in significantly improved disease outcome. Furthermore, isavuconazole treatment reduced the levels of inflammatory cytokines (tumor necrosis factor α [TNF-α], interleukin 1β [IL-1β], and IL-6) and cellular infiltration in the eyes. Notably, oral administration of isavuconazole was as effective in ameliorating endophthalmitis as intravitreal injection of the drug. Collectively, our study demonstrates that isavuconazole is effective in treating endophthalmitis in mice, indicating its potential use in human ocular infections.

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mentioning

confidence: 99%

Isavuconazole for Treatment of Experimental Fungal Endophthalmitis Caused by Aspergillus fumigatus

Guest

Singh

Revankar

et al. 2018

Antimicrob Agents Chemother

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“…Given that fungal infection is usual in immunocompromised individuals, we assumed that there were undetected underlying ocular disorders. 8 The eyelid disorder, such as blepharitis, might have predisposed our patient to keratitis, and prolonged the course of treatment. 9 The relationship between A. flavus infection and blepharitis remains controversial.…”

Section: Discussionmentioning

confidence: 93%

Recurrent Fungal Keratitis and Blepharitis Caused by Aspergillus flavus

Lee

Sun

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Aspergillus species produces a wide spectrum of fungal diseases like endophthalmitis and fungal keratitis ophthalmologically, but there has been no report about blepharitis caused by Aspergilus flavus to date. Herein, we report a 61-year-old ethnic Han Taiwanese male who had suffered from pain with burning and foreign body sensation after an insect bite on his left eye. Specimens from bilateral eyelids suggested infection of A. flavus, whereas corneal scraping showed the presence of Gram-negative bacteria. He was admitted for treatment of infectious keratitis with topical antibiotic and antifungal eye drops. Two weeks after discharge, recurrent blepharitis and keratitis of A. flavus was diagnosed microbiologically. Another treatment course of antifungal agent was resumed in the following 6 months, without further significant symptoms in the following 2 years. Collectively, it is possible for A. flavus to induce concurrent keratitis and blepharitis, and combined treatment of keratitis as well as blepharitis is advocated for as long as 6 months to ensure no recurrence.

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“…25 Fusarium and Candida are common causes among the variety of implicated species. 25,36 Risks of such infection include neutropenia, human immunodeficiency virus/AIDS and intravenous drug abuse. Symptoms include pain, redness and decreased or blurred vision.…”

Section: Eye Infections From Freshwatermentioning

confidence: 99%