Prolongierte topische Natamycin 5 %-Therapie vor und nach Keratoplastik bei Fusarium-Keratitis

Cvetkova, Nadezhda; Köstler, Josef; Prahs, Philipp; Helbig, Horst; Dietrich-Ntoukas, Tina

doi:10.1007/s00347-015-0111-x

Cited by 2 publications

(3 citation statements)

References 11 publications

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“…In the literature, good efficacy of natamycin in eye infections caused by Fusarium spp. has been reported (7,42,53). Natamycin was rarely used in our patient population (n ϭ 5), but it may have been effective, since three of four patients treated with natamycin and who had a known outcome preserved at least some eye sight.…”

Section: Discussionmentioning

confidence: 78%

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Fusarium Keratitis in Germany

et al. 2017

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keratitis is a destructive eye infection that is difficult to treat and results in poor outcome. In tropical and subtropical areas, the infection is relatively common and associated with trauma or chronic eye diseases. However, in recent years, an increased incidence has been reported in temperate climate regions. At the German National Reference Center, we have observed a steady increase in case numbers since 2014. Here, we present the first German case series of eye infections with species. We identified isolates from the eye or eye-related material from 22 patients in 2014 and 2015. Thirteen isolates belonged to the species complex (FSSC), 6 isolates belonged to the species complex (FOSC), and three isolates belonged to the species complex (FFSC). FSSC was isolated in 13 of 15 (85%) definite infections and FOSC in 3 of 4 (75%) definite contaminations. Furthermore, diagnosis from contact lens swabs or a culture of contact lens solution turned out to be highly unreliable. FSSC isolates differed from FOSC and FFSC by a distinctly higher MIC for terbinafine. Outcome was often adverse, with 10 patients requiring keratoplasty or enucleation. The use of natamycin as the most effective agent against keratitis caused by filamentous fungi was rare in Germany, possibly due to restricted availability. Keratitis caused by spp. (usually FSSC) appears to be a relevant clinical problem in Germany, with the use of contact lenses as the predominant risk factor. Its outcome is often adverse.

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Section: Discussionmentioning

confidence: 78%

“…In addition to local treatment, more invasive management, including corneal transplantation (54) and even enucleation (7% of enucleations were due to Fusarium in an eye hospital in Thailand [8]), has been reported. Long duration of antifungal treatment seems to be required due to common recurrence of infection (53,54).…”

Section: Discussionmentioning

confidence: 99%

Fusarium Keratitis in Germany

et al. 2017

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“…[39,40]. A prolonged topical therapy using natamycin (5%) is reported as an option to prevent progression or recurrence [41], using increased concentrations hourly or in even shorter treatment intervals and trying to achieve an effective local concentration through topical application. Since the half-life of topically administered drugs is only about 4 min [42], it is recommended that the eye lids should remain closed for about two minutes, so that definitely higher amounts of the agents will persist in the tear film than compared to active movements of the lids [43].…”

Section: Discussionmentioning

confidence: 99%

Malignant Keratitis Caused by a Highly-Resistant Strain of Fusarium Tonkinense from the Fusarium Solani Complex

Schrecker¹,

Seitz

Berger

et al. 2021

JoF

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Fusarium spp. are moulds ubiquitously distributed in nature and only occasionally pathogenic for humans. Species of the Fusarium solani complex are the predominant keratitis-inducing pathogens, because they are endowed with proper virulence factors. These fungi can adhere to the cornea creating a biofilm and, with the help of enzymes and cytotoxins, penetrate the cornea. Whereas an intact cornea is hardly able to be invaded by Fusarium spp. in spite of appropriate virulence factors, these opportunistic fungi may profit from predisposing conditions, for example mechanical injuries. This can lead to a progressive course of corneal infection and may finally affect the whole eye up to the need for enucleation. Here, we present and discuss the clinical, microbiological and histopathological aspects of a particular case due to Fusarium tonkinense of the Fusarium solani complex with severe consequences in a patient without any obvious predisposing factors. A broad portfolio of antifungal agents was applied, both topically and systemically as well as two penetrating keratoplasties were performed. The exact determination of the etiologic agent of the fungal infection proved likewise to be very challenging.

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Prolongierte topische Natamycin 5 %-Therapie vor und nach Keratoplastik bei Fusarium-Keratitis

Abstract: In the case described here, there was a clear corneal graft without Fusarium recurrence 1 year after surgery and it is presumed the prolonged antifungal therapy before and after surgery was an important factor for this clinical outcome.

Cited by 2 publications

References 11 publications

Fusarium Keratitis in Germany

Fusarium Keratitis in Germany

Malignant Keratitis Caused by a Highly-Resistant Strain of Fusarium Tonkinense from the Fusarium Solani Complex

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