Ocular mycosis at a referral center in Saudi Arabia: A 20-year study

Jastaneiah, Sabah; Al‐Rajhi, Ali A.; Abbott, David M.

doi:10.1016/j.sjopt.2011.04.004

Cited by 22 publications

(24 citation statements)

References 23 publications

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“…Salera et al found 60% of infections by Fusarium and 30% by Aspergillus, both filamentous fungi (17) ; Santos et al also found a predominance of filamentous fungi, but the most common were Penicillium and Cladosporium (16) ; Carvalho et al found that filamentous fungi were relatively more common, with 32% by Fusarium, 17% by Aspergillus and 10% by Penicillium (18) ; Dalfré et al found 44% by Fusarium and 23% by Geotricum (14) . With regard to other countries, in the United States Aspergillus was the most frequently isolated fungus; in Saudi Arabia, the most common were Aspergillus and Trycophytum, both filamentous (22) ; in Japan, Fusarium and Aspergillus (23) ; in India, Fusarium and Aspergillus were also the most frequent (24) ; and the same was found in China, where filamentous fungi were found in 90% of cases (25) . Table 3 shows the high number of cases related to previous surgery.…”

Section: Discussionmentioning

confidence: 84%

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Reflexões sobre a ceratite fúngica por meio dos achados de exames histopatológicos

Monte

Stadtherr

2013

Rev. bras.oftalmol.

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Purpose: The study of fungal invasion and pathogenicity in corneal tissue observed through the histopathological examination of specimens obtained through penetrating keratoplasty ('PKP') of samples obtained from an Eye Bank ('EB'), with the aim of applying findings in diagnosis and treatment of the condition (n=35), a faixa etária acima de 60 anos a mais numerosa com 1/3 dos pacientes. Os casos de ceratite fúngica correspondiam à média de 6,4% (n=597) do material recebido no BOO e 1,65% (n=2310) dos transplantes ocorrido com o material fornecido nos últimos 5 anos. Pelas informações dos cirurgiões 39,5% (n=38) dos casos deviam-se a perfuração corneana. Usando as datas dos transplantes foi feita uma Tábua de Observação. Em 11 (n=38) casos, a córnea procedia de transplante anterior. As formas leveduriformes nos tecidos corneanos eram de 63% (n=38). Em 50% (n=38) dos casos o infiltrado inflamatório era pequeno ou inexistente. A camada de Descemet estava íntegra em 13% (n=38), enquanto eram encontrados fungos na superfície corneana de 45% (n=38) dos casos. Conclusão: A coleta do material poderá ser feita com sucesso mesmo depois de instalado o tratamento, entretanto, nas úlceras de córnea deve ser feito preferentemente a coleta de material com espátula para exame laboratorial e a microscopia confocal in vivo. A predominância das leveduras poderá ser devido a alterações morfológicas do fungo sofridas no tecido corneano. A penetração intraocular é facilitada por alterações da Camada de Descemet e pela própria capacidade do fungo de penetrar nos tecidos justificando o tratamento sistêmico desde o início. Descritores: Ceratite/diagnóstico; Ceratite/patologia; Infecções oculares fúngicas/diagnósticoThe authors declare no conflicts of interest

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Section: Discussionmentioning

confidence: 84%

“…Similar results were found in Saudi Arabia. Jastaneiah et al found that 38.7% of cases had surgery prior to the diagnosis of fungal keratitis (22) . As can be seen in Figures 1C and 1D, the organisms remain on the surface of the cornea.…”

Section: Discussionmentioning

confidence: 99%

Reflexões sobre a ceratite fúngica por meio dos achados de exames histopatológicos

Monte

Stadtherr

2013

Rev. bras.oftalmol.

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“…An increase in its incidence has been reported in recent decades (4)(5)(6) , but the disease is still a challenge in terms of diagnosis and treatment (5,7) . Regarding microbial ceratites, fungal ceratites are reported in 16.4% of cases in Parana (Brazil) (8) , 10.3% and 14.0% of cases in Saudi Arabia (5,9) , 8% of cases in San Francisco (California, United States) (10) and 38.06%, 39.8% and 36.79% of cases in India (2,11,12) . Two basic forms of fungal keratitis are recognized: one due to filamentous fungi (especially Fusarium and Aspergillus) which commonly occurs in tropical and subtropical zones, and another due to yeast fungi or related (in particular Candida) (13) .…”

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confidence: 99%

“…However, most epidemiological studies on mycotic keratitis are based on observations of corneal material used to prepare the slides and/or culture (4,8,9,11,12,18) . Few studies talk about histopathological characteristics of fungal keratitis (22) or mention a histopathological examination carried out during the study of the epidemiology of fungal keratitis (2,5,16,20) . Among the latter, none uses exclusive information for the histopathological exam, Bras Oftalmol.…”

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confidence: 99%

“…Among the latter, none uses exclusive information for the histopathological exam, Bras Oftalmol. 2016; 75 (3): [195][196][197][198][199][200][201][202][203][204] and some do not describe in details the findings of this exam (2,5) . It is important, however, to submit surgical samples of microbial keratitis cases to histopathological examination, especially if the microbiological diagnosis is unknown (23) .…”

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Epidemiology of fungal keratitis treated with penetrating keratoplasty by means of histopathologic findings

Ximenes¹,

Vasconcelos²,

Monte³

2016

Revista Brasileira De Oftalmologia

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RESUMOObjetivo: Estudar, através do exame histopatológico, a epidemiologia de ceratites fúngicas tratadas com ceratoplastia penetrante terapêutica, enfatizando a presença de cirurgia ocular prévia. Métodos: Inicialmente, o estudo foi observacional e transversal de botões corneanos provenientes de ceratoplastia penetrante no período de 2006-2015 enviados para exame histopatológico ao banco de olhos do Hospital Geral de Fortaleza. Os tecidos foram corados com Hematoxilina-eosina, PAS ou Grocott, e examinados com microscópio óptico. Foram selecionados casos com diagnóstico histopatológico de ceratite fúngica. Após a selecão, realizamos revisão de prontuários buscando idade e sexo do paciente, data(s) do(s) transplante(s) por ceratite fúngica, diagnóstico clínico pré-cirúrgico, presença/tipo de cirurgias anteriores e/ou posteriores. Incluímos 62 botões corneanos de 55 pacientes. Resultados: A maioria dos pacientes era do sexo masculino. Apenas 7 (11,29%) casos tiveram recidiva da infecção tratada cirurgicamente. 10 (16,13%) casos possuíam cirurgia ocular prévia a ceratite fúngica tratada por transplante. Nenhum caso teve ceratite fúngica como diagnóstico clínico pré-cirúrgico. A principal forma de fungo no exame histopatológico foi forma leveduriforme isolada, seguida pela leveduriforme associada à filamentosa. O aspecto predominante da membrana de Descemet foi livre de fungos. Conclusão: Demonstramos o potencial curativo das ceratites fúngicas quando tratadas com ceratoplastia penetrante terapêutica e uma possível associação do fator cirurgia ocular prévia ao desenvolvimento dessas infecções. Características do exame histopatológico foram abordadas diferente de outros estudos que, em sua maioria, citam apenas o exame microbiológico. A dificuldade no diagnóstico clínico pré-cirúrgico foi ressaltada, o que pode ter contribuído com a evolução dos casos estudados para tratamento cirúrgico.Descritores: Ceratite/epidemiologia; Ceratite/patologia; Infecções oculares fúngicas; Ceratoplastia penetrante

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Aspergillus flavus endophthalmitis after penetrating keratoplasty combined with cataract phacoemulsification and IOL implantation

et al. 2014

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To report the clinical findings and management of a case of Aspergillus flavus endophthalmitis following penetrating keratoplasty (PKP) and combined cataract extraction. Clinical cornea appearance was evaluated by slit-lamp examination. Ocular ultrasonography was performed to evaluate the anterior chamber and vitreous cavity. The cornea was scraped. The corneal-scleral donor rim and media were cultured. The diagnosis of A. flavus infection was made. The patient received fortified antifungal drops (voriconazole 1 % solution) plus systemic voriconazole 400 mg/die. A second corneal transplant was performed, and the anterior chamber was cleaned and washed with a solution of voriconazole 1 %. At the end of follow-up, CDVA was 20/20 and slit-lamp examination showed a clear cornea graft. This case illustrates a severe A. flavus endophthalmitis after PKP and demonstrates the possibilities of visual function restoration. Furthermore, this case describes the different sources of fungal infection after PKP and the different clinical appearances.

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Ocular mycosis at a referral center in Saudi Arabia: A 20-year study

Cited by 22 publications

References 23 publications

Reflexões sobre a ceratite fúngica por meio dos achados de exames histopatológicos

Reflexões sobre a ceratite fúngica por meio dos achados de exames histopatológicos

Epidemiology of fungal keratitis treated with penetrating keratoplasty by means of histopathologic findings

Aspergillus flavus endophthalmitis after penetrating keratoplasty combined with cataract phacoemulsification and IOL implantation

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