1/128. Endogenous endophthalmitis: case report and brief review.Endogenous endophthalmitis is a potentially blinding ocular infection resulting from hematogenous spread from a remote primary source. The condition is relatively rare but may become more common as the number of chronically debilitated patients and the use of invasive procedures increase. Many etiologic organisms (gram-positive, gram-negative and fungal) have been reported to cause endogenous endophthalmitis. risk factors are well defined and include most reasons for immune suppression. A high clinical suspicion is needed for early diagnosis and treatment. Early intravenous antibiotic therapy remains the cornerstone of treatment. The roles of intravitreal antibiotics and vitrectomy are evolving and may become more widely accepted as therapeutic modalities. The authors report a case of endogenous endophthalmitis and provide a brief review of the literature.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
2/128. chrysosporium parvum keratomycosis.PURPOSE: To report a case of corneal infection with chrysosporium parvum, a filamentous fungus usually associated with pulmonary infections. methods: A 43-year-old Saudi man had a corneal stromal infiltrate and perforation of his left eye. He was treated with a therapeutic penetrating keratoplasty and topical and systemic antifungal therapy. Corneal scrapings, microbiologic evaluation, and histopathologic examination of the surgical specimen were performed to establish the diagnosis. After the development of recurrent stromal keratitis at the graft-host junction, similar diagnostic and therapeutic maneuvers were performed. RESULTS: Corneal scrapings and histopathologic examination were positive for numerous septate hyphae with endospores, consistent with a diagnosis of filamentous keratomycosis. Microbiologic isolation confirmed the diagnosis of chrysosporium parvum. Similar diagnostic maneuvers for recurrent keratitis produced identical results. CONCLUSION: To our knowledge, this is the first case of chrysosporium parvum keratomycosis.- - - - - - - - - - ranking = 19657.883887659keywords = keratitis (Clic here for more details about this article) |
3/128. exophiala jeanselmei causing late endophthalmitis after cataract surgery.PURPOSE: To report two cases of late endophthalmitis caused by exophiala jeanselmei after cataract surgery. methods: case reports, including clinical evaluation, direct examination, and culture of the aqueous humor. RESULTS: In each case, samples from the anterior chamber had positive growth of yeasts with toruloid hyphae and pseudohyphae. Intravitreal and anterior chamber amphotericin B were used in both cases. Apparent clinical resolution was achieved, but after 3 months in one case and 6 months in the other the infection recurred more aggressively, with severe endophthalmitis leading to ocular atrophy. CONCLUSION: E. jeanselmei causes a severe intraocular infection and isolation, and identification of the agent ensures proper diagnosis and treatment. After clinical resolution of the infection, careful and long-term follow-up is recommended to promptly detect relapse and immediately reintroduce treatment.- - - - - - - - - - ranking = 2keywords = ocular (Clic here for more details about this article) |
4/128. acremonium keratitis in a patient with herpetic neurotrophic corneal disease.fungi belonging to the genus acremonium Link ex Fries 1821 are ubiquitous environmental contaminants and soil saprophytes, but are infrequent pathogens in humans. These filamentous fungi (previously known as Cephalosporium) are an uncommon cause of mycotic keratitis. As in the case of other filamentous fungi, corneal trauma with contaminated matter is the most frequent risk factor for the infection. We report in this paper a case of keratomycosis caused by Acremoniumpotronii, in a patient with a history of herpetic keratitis. Medical treatment with amphotericin b was unsuccessful and the infection eventually resolved with penetrating keratoplasty.- - - - - - - - - - ranking = 58973.651662978keywords = keratitis (Clic here for more details about this article) |
5/128. Fungal keratitis after laser in situ keratomileusis: a case report.PURPOSE: To report a case of fungal keratitis resulting after laser in situ keratomileusis (LASIK). methods: A 38-year-old white man in good health developed a corneal infiltrate with laboratory confirmation of fungal keratitis after LASIK. Corneal scrapings were taken. silver stain was positive for hyphae. culture was positive for Curvularia sp. The patient was started on intensive natamycin 5% and amphotericin 0.15% topical therapy. RESULTS: The patient's keratitis was successfully treated with intensive antifungal therapy. CONCLUSIONS: Infectious keratitis is a rare but a serious potential complication after LASIK. To our knowledge, no previous case of fungal keratitis after LASIK has been reported. This case emphasizes the importance of surveillance for infection after LASIK.- - - - - - - - - - ranking = 88460.477494467keywords = keratitis (Clic here for more details about this article) |
6/128. Medical management of beauveria bassiana keratitis.PURPOSE: To describe a case of beauveria bassiana keratitis and to discuss the management of this rare condition. methods: An 82-year-old woman underwent surgical repair of a graft wound dehiscence. Seven months later, shortly after the removal of sutures, the patient developed a fungal keratitis. B. bassiana was identified as the infecting organism. The patient was treated with topical natamycin and oral fluconazole. RESULTS: Following antifungal therapy, the corneal ulcer was eradicated, but the patient underwent repeat penetrating keratoplasty for decreased vision due to corneal edema. The graft remains clear and visual acuity is substantially improved. CONCLUSION: The medical management of B. bassiana keratitis has previously been unsuccessful. The use of topical natamycin combined with oral fluconazole in the management of this case is discussed.- - - - - - - - - - ranking = 68802.593606808keywords = keratitis (Clic here for more details about this article) |
7/128. Lasiodiplodia theobromae as a cause of keratomycoses.Four cases of human keratitis caused by the tropical fungus Lasiodiplodia theobromae have been encountered in Miami, florida bringing to 8 the number of cases reported in the world literature. Two of the ulcers were mild. Three patients recovered without severe impairment of vision after topical polyene treatment, but 1 patient with a severe ulcer required therapeutic keratoplasty after 11 days of topical natamycin. Histopathology revealed fungus deep in the cornea, invading Descemet's membrane. L. theobromae appeared to have collagenase activity in vitro. Inoculation of L. theobromae into the corneas of rabbits produced progressive ulcers. The fungus was endemic in Miami on home grown and imported bananas. Polyene antimycotic antibiotics were fungicidal for L. theobromae in vitro. thiabendazole was effectively fungistatic but varied in fungicidal effect. clotrimazole and miconazole were only incompletely fungistatic. Of 7 strains of L. theobromae tested, 4 were relatively resistant to 5-flurocytosine.- - - - - - - - - - ranking = 9828.9419438297keywords = keratitis (Clic here for more details about this article) |
8/128. Fungal keratitis in a soft contact lens wearer.PURPOSE: To describe a case of fungal keratitis in a soft contact lens wearer. methods AND RESULTS: A 57 year old female, compliant, frequent replacement soft contact lens wearer, with a possible prior history of herpes simplex keratitis, presented with pain and injection of her left eye of four weeks duration. Gram stain of a corneal ulcer of the left eye revealed fungal organisms and cultures grew fusarium solani. The infiltrate responded to topical and systemic antifungal agents, but a corneal perforation developed which required a therapeutic penetrating keratoplasty. CONCLUSIONS: Fungal infections are a cause of corneal ulcers in contact lens wearers. Despite the use of topical and systemic antifungal agents, fungal ulcers frequently require surgical intervention.- - - - - - - - - - ranking = 58997.669511378keywords = keratitis, herpes simplex, simplex, herpes (Clic here for more details about this article) |
9/128. exophiala werneckii endophthalmitis following cartaract surgery in an immunocompetent individual.A case of infectious endophthalmitis caused by the saprophyte exophiala werneckii is reported. This has not been recognized as a pathogen for ocular infections previously. The infection followed uncomplicated cataract surgery involving phacoemulsification and IOL implant. Clinical presentation was that of an indolent endophthalmitis with relatively acute onset. Pars plana vitrectomy, fungal stains, and culture established the diagnosis. Initial management consisted of empirical intravitreal injection of vancomycin, ceftazidime, and amphotericin b. Treatment was supplemented with a 3-week course of systemic fluconazole and topical therapy with natamycin, atropine, ciprofloxacin, and diclofenac. The visual acuity returned to 20/20-2 with no recurrence of infection. The source of the infection could not be determined. Fungal endophthalmitis has to be considered as a rare, though important, complication following ophthalmic surgery. Specific fungal stains and cultures are helpful for establishing the diagnosis early in the course of disease. E werneckii should be considered in the differential diagnosis of fungal endophthalmitis.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
10/128. Treatment of postkeratitis fusarium endophthalmitis with amphotericin b lipid complex.PURPOSE: The authors report the first case of fusarium solani keratitis that progressed to fungal endophthalmitis and was successfully treated with amphotericin b lipid complex (ABLC). METHOD: The case of a 34-year-old immunocompetent woman who developed a contact lens-related F. solani keratitis requiring emergency penetrating keratoplasty (PKP) was analyzed. The immunocompetent patient developed fungal endophthalmitis (anterior chamber tap positive for F. solani three months after PKP) and was eventually treated with ABLC. RESULTS: Systemic amphotericin b (total, 0.42 g) and ketoconazole in addition to topical natamycin and amphotericin did not prove to be effective in eradicating the mycosis in the anterior chamber. Under ABLC treatment (total, 8.79 g), the anterior chamber inflammation resolved completely. No recurrence was observed during an 11-month follow-up after treatment was discontinued. CONCLUSION: ABLC proved to be effective in treating F. solani endophthalmitis. It is an important addition to the ophthalmic armamentarium, and appeared to be a better therapeutic agent than standard amphotericin b in this patient.- - - - - - - - - - ranking = 58973.651662978keywords = keratitis (Clic here for more details about this article) |
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