Jundishapur Journal of Microbiology

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Mycotic Keratitis, a State-of-the-Art Review

Parisa Badiee 1 , *
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1 Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
Article information
  • Jundishapur Journal of Microbiology: July 01, 2013, 6 (5); e8561
  • Published Online: July 1, 2013
  • Article Type: Review Article
  • Received: October 13, 2012
  • Revised: January 13, 2013
  • Accepted: January 22, 2013
  • DOI: 10.5812/jjm.8561

To Cite: Badiee P. Mycotic Keratitis, a State-of-the-Art Review, Jundishapur J Microbiol. 2013 ; 6(5):e8561. doi: 10.5812/jjm.8561.

Copyright © 2013, Ahvaz Jundishapur University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Etiologic Agents
3. Epidemiology
4. Diagnosis of Fungal Keratitis
5. Treatment of Fungal Keratitis
6. Conclusions
  • 1. Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness: a global perspective. Bull World Health Organ. 2001; 79(3): 214-21[PubMed]
  • 2. Whitcher JP, Srinivasan M, Upadhyay MP. Prevention of corneal ulceration in the developing world. Int Ophthalmol Clin. 2002; 42(1): 71-7[PubMed]
  • 3. Upadhyay MP, Karmacharya PC, Koirala S, Shah DN, Shakya S, Shrestha JK, et al. The Bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal. Br J Ophthalmol. 2001; 85(4): 388-92[PubMed]
  • 4. Bharathi MJ, Ramakrishnan R, Meenakshi R, Padmavathy S, Shivakumar C, Srinivasan M. Microbial keratitis in South India: influence of risk factors, climate, and geographical variation. Ophthalmic Epidemiol. 2007; 14(2): 61-9[DOI][PubMed]
  • 5. Barnes SD, Pavan Langston D, Azar DT. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 2010; 1: 1539
  • 6. Riddell Iv J, McNeil SA, Johnson TM, Bradley SF, Kazanjian PH, Kauffman CA. Endogenous Aspergillus endophthalmitis: report of 3 cases and review of the literature. Medicine (Baltimore). 2002; 81(4): 311-20[PubMed]
  • 7. Thomas PA, Leck AK, Myatt M. Characteristic clinical features as an aid to the diagnosis of suppurative keratitis caused by filamentous fungi. Br J Ophthalmol. 2005; 89(12): 1554-8[DOI][PubMed]
  • 8. Badiee P, Alborzi A, Farhoudi F. A case of Candida mediastinitis after dental extraction. J Infect Dev Ctries. 2011; 5(1): 75-8[PubMed]
  • 9. Tilak R, Singh A, Maurya OP, Chandra A, Tilak V, Gulati AK. Mycotic keratitis in India: a five-year retrospective study. J Infect Dev Ctries. 2010; 4(3): 171-4[PubMed]
  • 10. Reddy PS, Satyendran OM, Satapathy M, Kumar HV, Reddy PR. Mycotic keratitis. Indian J Ophthalmol. 1972; 20(3): 101-8[PubMed]
  • 11. Ghannoum MA. Potential role of phospholipases in virulence and fungal pathogenesis. Clin Microbiol Rev. 2000; 13(1): 122-43[PubMed]
  • 12. Nayak N. Fungal infections of the eye--laboratory diagnosis and treatment. Nepal Med Coll J. 2008; 10(1): 48-63[PubMed]
  • 13. Thomas PA. Fungal infections of the cornea. Eye (Lond). 2003; 17(8): 852-62[DOI][PubMed]
  • 14. Chander J, Singla N, Agnihotri N, Arya SK, Deep A. Keratomycosis in and around Chandigarh: a five-year study from a north Indian tertiary care hospital. Indian J Pathol Microbiol. 2008; 51(2): 304-6[PubMed]
  • 15. Badiee P, Alborzi A, Nejabat M. Detection of Aspergillus keratitis in ocular infections by culture and molecular method. Int Ophthalmol. 2011; 31(4): 291-6[DOI][PubMed]
  • 16. Badiee P, Nejabat M, Alborzi A, Keshavarz F, Shakiba E. Comparative study of Gram stain, potassium hydroxide smear, culture and nested PCR in the diagnosis of fungal keratitis. Ophthalmic Res. 2010; 44(4): 251-6[DOI][PubMed]
  • 17. Khanal B, Kaini KR, Deb M, Badhu B, Thakur SK. Microbial keratitis in eastern Nepal. Trop Doct. 2001; 31(3): 168-9[PubMed]
  • 18. Chander J, Chakrabarti A, Sharma A, Saini JS, Panigarhi D. Evaluation of Calcofluor staining in the diagnosis of fungal corneal ulcer. Mycoses. 1993; 36(7-8): 243-5[PubMed]
  • 19. Saha R, Das S. Mycological profile of infectious Keratitis from Delhi. Indian J Med Res. 2006; 123(2): 159-64[PubMed]
  • 20. Chowdhary A, Singh K. Spectrum of fungal keratitis in North India. Cornea. 2005; 24(1): 8-15[PubMed]
  • 21. Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Palaniappan R. Epidemiological characteristics and laboratory diagnosis of fungal keratitis. A three-year study. Indian J Ophthalmol. 2003; 51(4): 315-21[PubMed]
  • 22. Leck AK, Thomas PA, Hagan M, Kaliamurthy J, Ackuaku E, John M, et al. Aetiology of suppurative corneal ulcers in Ghana and south India, and epidemiology of fungal keratitis. Br J Ophthalmol. 2002; 86(11): 1211-5[PubMed]
  • 23. Thomas PA. Mycotic keratitis--an underestimated mycosis. J Med Vet Mycol. 1994; 32(4): 235-56[PubMed]
  • 24. Poole TR, Hunter DL, Maliwa EM, Ramsay AR. Aetiology of microbial keratitis in northern Tanzania. Br J Ophthalmol. 2002; 86(8): 941-2[PubMed]
  • 25. Vemuganti GK, Garg P, Gopinathan U, Naduvilath TJ, John RK, Buddi R, et al. Evaluation of agent and host factors in progression of mycotic keratitis: A histologic and microbiologic study of 167 corneal buttons. Ophthalmology. 2002; 109(8): 1538-46[PubMed]
  • 26. Sharma S, Silverberg M, Mehta P, Gopinathan U, Agrawal V, Naduvilath TJ. Early diagnosis of mycotic keratitis: predictive value of potassium hydroxide preparation. Indian J Ophthalmol. 1998; 46(1): 31-5[PubMed]
  • 27. Shokohi T, Nowroozpoor-Dailami K, Moaddel-Haghighi T. Fungal keratitis in patients with corneal ulcer in Sari, Northern Iran. Arch Iran Med. 2006; 9(3): 222-7[PubMed]
  • 28. Vajpayee RB, Angra SK, Sandramouli S, Honavar SG, Chhabra VK. Laboratory diagnosis of keratomycosis: comparative evaluation of direct microscopy and culture results. Ann Ophthalmol. 1993; 25(2): 68-71[PubMed]
  • 29. Tanure MA, Cohen EJ, Sudesh S, Rapuano CJ, Laibson PR. Spectrum of fungal keratitis at Wills Eye Hospital, Philadelphia, Pennsylvania. Cornea. 2000; 19(3): 307-12[PubMed]
  • 30. Vengayil S, Panda A, Satpathy G, Nayak N, Ghose S, Patanaik D, et al. Polymerase chain reaction-guided diagnosis of mycotic keratitis: a prospective evaluation of its efficacy and limitations. Invest Ophthalmol Vis Sci. 2009; 50(1): 152-6[DOI][PubMed]
  • 31. Badiee P, Alborzi A, Joukar M. Molecular assay to detect nosocomial fungal infections in intensive care units. Eur J Intern Med. 2011; 22(6): 611-5[DOI][PubMed]
  • 32. Badiee P, Alborzi A, Shakiba E, Farshad S, Japoni A. Susceptibility of Candida species isolated from immunocompromised patients to antifungal agents. East Mediterr Health J. 2011; 17(5): 425-30[PubMed]
  • 33. Badiee P, Alborzi A, Davarpanah MA, Shakiba E. Distributions and antifungal susceptibility of Candida species from mucosal sites in HIV positive patients. Arch Iran Med. 2010; 13(4): 282-7[PubMed]
  • 34. Ferrer C, Alio JL. Evaluation of molecular diagnosis in fungal keratitis. Ten years of experience. J Ophthalmic Inflamm Infect. 2011; 1(1): 15-22[DOI][PubMed]
  • 35. Badiee P, Kordbacheh P, Alborzi A, Malekhoseini SA. Invasive fungal infection in renal transplant recipients demonstrated by panfungal polymerase chain reaction. Exp Clin Transplant. 2007; 5(1): 624-9[PubMed]
  • 36. Badiee P, Alborzi A, Malekhosseini SA, Nikeghbalian S, Shakiba E. Determining the incidence of aspergillosis after liver transplant. Exp Clin Transplant. 2010; 8(3): 220-3[PubMed]
  • 37. Badiee P, Alborzi A, Shakiba E, Ziyaeyan M, Pourabbas B. Molecular diagnosis of Aspergillus endocarditis after cardiac surgery. J Med Microbiol. 2009; 58: 192-5[DOI][PubMed]
  • 38. Badiee P, Alborzi A. Assessment of a real-time PCR method to detect human non-cryptococcal fungal meningitis. Arch Iran Med. 2011; 14(6): 381-4[PubMed]
  • 39. Badiee P, Alborzi A. Detection of Aspergillus species in bone marrow transplant patients. J Infect Dev Ctries. 2010; 4(8): 511-6[PubMed]
  • 40. Badiee P, Alborzi A, Vojdani R, Shakiba E, Rasouli M, Ravanfar P, et al. Early diagnosis of systemic candidiasis in bone marrow transplant recipients. Exp Clin Transplant. 2010; 8(2): 98-103[PubMed]
  • 41. Ferrer C, Munoz G, Alio JL, Abad JL, Colomm F. Polymerase chain reaction diagnosis in fungal keratitis caused by Alternaria alternata. Am J Ophthalmol. 2002; 133(3): 398-9[PubMed]
  • 42. Anand A, Madhavan H, Neelam V, Lily T. Use of polymerase chain reaction in the diagnosis of fungal endophthalmitis. Ophthalmology. 2001; 108(2): 326-30[PubMed]
  • 43. Kumar M, Mishra NK, Shukla PK. Sensitive and rapid polymerase chain reaction based diagnosis of mycotic keratitis through single stranded conformation polymorphism. Am J Ophthalmol. 2005; 140(5): 851-857[DOI][PubMed]
  • 44. Kim E, Chidambaram JD, Srinivasan M, Lalitha P, Wee D, Lietman TM, et al. Prospective comparison of microbial culture and polymerase chain reaction in the diagnosis of corneal ulcer. Am J Ophthalmol. 2008; 146(5): 714-23[DOI][PubMed]
  • 45. Dahlgren MA, Lingappan A, Wilhelmus KR. The clinical diagnosis of microbial keratitis. Am J Ophthalmol. 2007; 143(6): 940-944[DOI][PubMed]
  • 46. Badiee Parisa, Alborzi A, Shakiba E, Ziyaeyan M, Rasuli M. Molecular Identification and In-Vitro Susceptibility of Candida albicans and C. dubliniensis Isolated from Immu-nocompromised Patients. Iranian Red Crescent Medical Journal. 2009; 11(4): 391-397
  • 47. Day S, Lalitha P, Haug S, Fothergill AW, Cevallos V, Vijayakumar R, et al. Activity of antibiotics against Fusarium and Aspergillus. Br J Ophthalmol. 2009; 93(1): 116-9[DOI][PubMed]
  • 48. Rahman MR, Johnson GJ, Husain R, Howlader SA, Minassian DC. Randomised trial of 0.2% chlorhexidine gluconate and 2.5% natamycin for fungal keratitis in Bangladesh. Br J Ophthalmol. 1998; 82(8): 919-25[PubMed]
  • 49. Sponsel W, Chen N, Dang D, Paris G, Graybill J, Najvar LK, et al. Topical voriconazole as a novel treatment for fungal keratitis. Antimicrob Agents Chemother. 2006; 50(1): 262-8[DOI][PubMed]
  • 50. Ozbek Z, Kang S, Sivalingam J, Rapuano CJ, Cohen EJ, Hammersmith KM. Voriconazole in the management of Alternaria keratitis. Cornea. 2006; 25(2): 242-4[PubMed]
  • 51. Bernal MD, Acharya NR, Lietman TM, Strauss EC, McLeod SD, Hwang DG. Outbreak of Fusarium keratitis in soft contact lens wearers in San Francisco. Arch Ophthalmol. 2006; 124(7): 1051-3[DOI][PubMed]
  • 52. Prajna NV, Mascarenhas J, Krishnan T, Reddy PR, Prajna L, Srinivasan M, et al. Comparison of natamycin and voriconazole for the treatment of fungal keratitis. Arch Ophthalmol. 2010; 128(6): 672-8[DOI][PubMed]
  • 53. Hariprasad SM, Mieler WF, Lin TK, Sponsel WE, Graybill JR. Voriconazole in the treatment of fungal eye infections: a review of current literature. Br J Ophthalmol. 2008; 92(7): 871-8[DOI][PubMed]
  • 54. O'Day DM, Head WS, Robinson RD, Clanton JA. Corneal penetration of topical amphotericin B and natamycin. Curr Eye Res. 1986; 5(11): 877-82[PubMed]
  • 55. Alfonso EC, Cantu-Dibildox J, Munir WM, Miller D, O'Brien TP, Karp CL, et al. Insurgence of Fusarium keratitis associated with contact lens wear. Arch Ophthalmol. 2006; 124(7): 941-7[DOI][PubMed]
  • 56. Lau D, Fedinands M, Leung L, Fullinfaw R, Kong D, Davies G, et al. Penetration of voriconazole, 1%, eyedrops into human aqueous humor: a prospective open-label study. Arch Ophthalmol. 2008; 126(3): 343-6[DOI][PubMed]
  • 57. Tu EY, McCartney DL, Beatty RF, Springer KL, Levy J, Edward D. Successful treatment of resistant ocular fusariosis with posaconazole (SCH-56592). Am J Ophthalmol. 2007; 143(2): 222-227[DOI][PubMed]
  • 58. Siatiri H, Daneshgar F, Siatiri N, Khodabande A. The effects of intrastromal voriconazole injection and topical voriconazole in the treatment of recalcitrant Fusarium keratitis. Cornea. 2011; 30(8): 872-5[DOI][PubMed]
  • 59. Sharma N, Agarwal P, Sinha R, Titiyal JS, Velpandian T, Vajpayee RB. Evaluation of intrastromal voriconazole injection in recalcitrant deep fungal keratitis: case series. Br J Ophthalmol. 2011; 95(12): 1735-7[DOI][PubMed]
  • 60. Tuli SS. Fungal keratitis. Clin Ophthalmol. 2011; 5: 275-9[DOI][PubMed]
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