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Thread: Fungal keratitis

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    Default Fungal keratitis

    There is a lot going on in this image. Hopefully the labels are helpful. This explanation is a summary taken from the BCSC: External Disease and Cornea text:
    Fungal keratitis represents less than 5%-10% of corneal infections in the United States. Filamentous fungal keratitis occurs more frequently in warmer, more humid regions. Corneal trauma with plant or vegetable material is the leading risk factor for fungal keratitis. Contact lens wear is another risk factor. Topical and oral corticosteroids are a major risk factor as well, as they reduce the cornea's resistance to infection.
    Filamentous fungal keratitis frequently manifests as a gray-white, dry-appearing infiltrate that has irregular feathery or filamentous margins.
    Corneal scrapings should be taken and cultured. Blood, Sabouraud's, and brain-heart infusion media are preferred media for fungal culture. Confocal microscopy is useful in detecting branching filaments as well as individual septa found in most corneal mold pathogens.
    Natamycin 5% suspension is recommended for treatment of most cases of filamentous fungal keratitis. Systemic administration may be considered for treatment of more severe keratitis. Oral voriconazole and posaconazole are rapidly replacing other oral antifungals because of their excellent intraocular penetration and broader spectrum of coverage. Alternatively, intrastromal administration of aqueous-soluble amphotericin B or voriconazole as primary or secondary treatment of deep fungal keratitis, and intracameral injection of either agent for intraocular extension are becoming more widely validated.

    Image courtesy of [Hamilton eye institute]
    Fungal keratitis attachment.php?attachmentid=2957&d=1477478131

    Source:Piece of ophthalmology











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