Queratitis por Lasiodiplodia theobromae: comunicación de un caso y revisión de la literatura

Samudio, Margarita; Laspina, Florentina; Fariña, Norma; Franco, Alicia González; Kaspar, Herminia Miño de; Giusiano, Gustavo

doi:10.4067/s0716-10182014000600018

Cited by 17 publications

(9 citation statements)

References 32 publications

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“…Only a few case reports have given details of treatments and outcomes. Clinical response from medical therapy alone has been reported in 3 cases with the use of topical natamycin alone [3], and in 1 case combined with topical amphotericin B [4]. Treatment outcomes using azoles were poor, with disease progression to endophthalmitis and panophthalmitis [5, 6, 7, 8].…”

Section: Discussionmentioning

confidence: 99%

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Successful Treatment of Lasiodiplodia theobromae Keratitis – Assessing the Role of Voriconazole

Yiu

Wong

et al. 2016

Case Rep Ophthalmol

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Purpose: The aim of this paper is to report the successful management of the first case of Lasiodiplodia theobromae keratitis in Hong Kong. Methods: We conducted a case report. Results: A 43-year-old Chinese male with a history of diabetes developed left eye keratitis after a trauma during tree felling. Fungal keratitis was diagnosed using a confocal microscope on day 1, and L. theobromae was confirmed from the culture. He was given oral voriconazole, topical natamycin, and topical and intracameral amphotericin B. The patient’s condition improved after the initial treatment. However, there was a slow progression to descemetocele formation and impending perforation due to corneal melting. Penetrating keratoplasty was performed at 8 weeks after presentation. Final visual recovery was good with no recurrence of infection. The cornea remained clear. Conclusions: We report the first case of L. theobromae keratitis in Hong Kong, and it is the only case so far that involved the use of oral voriconazole in the combination therapy. Early recognition with the aid of confocal microscopy allowed the early start of treatment. The use of newer antifungal voriconazole topically and orally combined with topical amphotericin B appeared to be useful in the eradication of the fungus and prevention of recurrence. Intracameral antifungals might have improved the clinical management.

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Section: Discussionmentioning

confidence: 99%

“…However, all cases were complicated by recurrence of infection or graft failure. Except in some mild cases [3, 4], the final visual outcomes were generally poor.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Lasiodiplodia theobromae Keratitis – Assessing the Role of Voriconazole

Yiu

Wong

et al. 2016

Case Rep Ophthalmol

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“…igual a lo reportado en otros estudios (Gopinathan et al, 2002;Hernandez-Camarena et al, 2012;Hernández-Camarena et al, 2013;Moemen et al, 2015). La queratitis fúngica es una entidad de peor pronóstico que una infección bacteriana y requiere de un diagnóstico precoz para evitar consecuencias irreversibles (Samudio et al, 2014).…”

Section: Discussionunclassified

“…Es de distribución mundial, pero es más común en las regiones tropicales y subtropicales, 6 a 60% de las queratitis observadas son de etiología micótica, dependiendo principalmente de la localización geográfica, en algunos países en desarrollo representa aproximadamente el 50% de todos los casos de queratitis microbiana obtenidos en cultivo (Ibrahim et al, 2011;Samudio et al, 2014). Se considera una infección oportunista asociada principalmente a trauma ocular con materiales vegetales (Laspina et al, 2004;Moemen et al, 2015;Samudio et al, 2014). En países tropicales como Paraguay, la incidencia de queratitis por hongos es relativamente alta debido a las condiciones climáticas (Laspina et al, 2004;Samudio et al, 2014).…”

Section: Introductionunclassified

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Diagnostic utility of Gram staining for infectious keratitis

Duré

2017

Rev. ciente. UCSA

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RESUMENAntecedentes: La queratitis infecciosa es una patología oftálmica causada por bacterias y hongos, y raramente por parásitos. El éxito del tratamiento depende en gran medida del diagnóstico microbiológico precoz por lo que el rol del laboratorio es esencial. Objetivo: Evaluar la utilidad de la coloración de Gram comparada con el cultivo en el diagnóstico etiológico de las queratitis infecciosas. Metodología: En este estudio de pruebas diagnósticas se incluyeron muestras de raspado e hisopado corneal de pacientes con sospecha clínica de queratitis infecciosa remitidas de tres centros oftalmológicos de referencia de Asunción-Paraguay entre enero 2015 a mayo 2017. Del raspado se realizó frotis para coloración de Gram y cultivo para hongos, y del hisopado cultivo para bacterias. Resultados: De 216 muestras estudiadas, 75 (34,7%) fueron positivas por cultivo para hongos y 62 (28,7%) para bacterias. La sensibilidad de la coloración de Gram para hongos fue 94,7% (71/75), especificidad 95,0% (134/141); VPP 91,0% (71/78) y VPN 97,1% (134/138). Para bacterias, la sensibilidad fue 74,2% (46/62), especificidad 99,4% (153/154); VPP 97,9% (46/47) y VPN 90,5% (153/169). Fusarium spp fue el hongo más frecuentemente aislado (45/75) y entre las bacterias Pseudomonas aeruginosa (16/62) y Streptococcus pneumoniae (13/62). Conclusión: La coloración de Gram tuvo buen desempeño diagnóstico para las queratitis micóticas, constituyéndose en una herramienta sencilla y rápida disponible en cualquier laboratorio de microbiología. Sin embargo, la sensibilidad para bacterias fue relativamente baja, lo que puede deberse en algunos casos al escaso material e inadecuada distribución de la muestra en el frotis dificultando la observación. Palabras clave: queratitis infecciosa; cultivo; coloración de Gram; utilidad diagnóstica.ABSTRACT Background: Infectious keratitis is an ophthalmic pathology caused by bacteria and fungi, and rarely by parasites. The success of the treatment depends to a great extent on the early microbiological diagnosis; therefore the role of the laboratory is essential. Objective: To evaluate the usefulness of Gram staining compared to culture in the etiological diagnosis of infectious keratitis. Methodology: In this study of diagnostic tests, corneal scraping and swab specimens from patients with clinical characteristics of infectious keratitis

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Invasive Fungal Sinusitis by Lasiodiplodia theobromae in an Patient with Aplastic Anemia: An Extremely Rare Case Report and Literature Review

Kim

Lee

et al. 2016

Mycopathologia

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Human Lasiodiplodia theobromae infection has not been reported frequently. We report the first case of invasive L. theobromae nasal and neck infection. A 66-year-old male visited our hospital with anemia and general weakness. He showed pancytopenia, and his bone marrow examination revealed markedly decreased hematopoietic cells. The patient was presumed to have iatrogenic aplastic anemia due to mushroom toxicity. He began treatment for multiple organ infections with broad-spectrum antibiotics and antifungal agents. During hospitalization, he complained of nasal obstruction and left neck lymph node enlargement. A mass-like lesion was observed, and a nasal mass biopsy was performed. The mass was identified as a fungal ball. He underwent surgical excision for the nasal mass and the neck lymph node. The pathologic examination indicated an invasive fungal infection, and the lymph node revealed chronic granulomatous inflammation with fungal infection. 18s rRNA sequencing revealed that the sequence shared 99 % identity with L. theobromae. The nasal mass fungus was identified by internal transcribed spacer region sequencing from pathologic paraffin sections. The obtained sequence corresponded to Lasiodiplodia or Macrophoma. The sequence corresponded to the neck discharge sequence results. Hence, the patient was diagnosed with invasive fungal sinusitis with neck lymph node involvement caused by L. theobromae. To our knowledge, this is the first report of L. theobromae infection in Korea and the first report of invasive L. theobromae fungal sinusitis in the literature. We should include more precise evaluations of additional novel fungal species as possible candidates.

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Queratitis por Lasiodiplodia theobromae: comunicación de un caso y revisión de la literatura

Cited by 17 publications

References 32 publications

Successful Treatment of Lasiodiplodia theobromae Keratitis – Assessing the Role of Voriconazole

Successful Treatment of Lasiodiplodia theobromae Keratitis – Assessing the Role of Voriconazole

Diagnostic utility of Gram staining for infectious keratitis

Invasive Fungal Sinusitis by Lasiodiplodia theobromae in an Patient with Aplastic Anemia: An Extremely Rare Case Report and Literature Review

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