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Fungal keratitis: An overview of clinical and laboratory aspects.
Mycoses. 2018 Dec; 61(12):916-930.M

Abstract

Mycotic keratitis or keratomycosis is a fungal infection with global distribution. The dominant aetiology of this disease varies based on geographical origin, socioeconomic status, and climatic condition. Generally, Aspergillus spp. and Fusarium spp. are common in tropical and subtropical regions and Candida spp. are dominant in temperate areas. Demonstration of fungal elements in microscopic examination besides the isolation of fungi in culture is the gold standard of laboratory diagnosis. As the culture is a time-consuming procedure, other approaches such as in vivo confocal microscopy which produces real-time imaging of corneal tissue and molecular techniques have been developed to facilitate rapid diagnosis of fungal keratitis. The first choice of treatment is topical natamycin, although topical amphotericin B is the best choice for Aspergillus and Candida keratitis. Regarding the diversity of fungal aetiology and the emergence of drug resistance in some genera and species, proper identification using molecular methods and antifungal susceptibility testing could provide useful data. Furthermore, as the better efficacy of combination therapy in comparison to monotherapy is reported, in vitro determination of interactions between various drugs seem informative. This review aims to provide a general and updated view on the aetiology, risk factors, epidemiology, clinical and laboratory diagnosis, and management of fungal keratitis.

Authors+Show Affiliations

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Ocular Trauma and Emergency, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.Department of Ocular Trauma and Emergency, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Ocular Trauma and Emergency, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.Department of Ocular Trauma and Emergency, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Ocular Trauma and Emergency, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29992633

Citation

Mahmoudi, Shahram, et al. "Fungal Keratitis: an Overview of Clinical and Laboratory Aspects." Mycoses, vol. 61, no. 12, 2018, pp. 916-930.
Mahmoudi S, Masoomi A, Ahmadikia K, et al. Fungal keratitis: An overview of clinical and laboratory aspects. Mycoses. 2018;61(12):916-930.
Mahmoudi, S., Masoomi, A., Ahmadikia, K., Tabatabaei, S. A., Soleimani, M., Rezaie, S., Ghahvechian, H., & Banafsheafshan, A. (2018). Fungal keratitis: An overview of clinical and laboratory aspects. Mycoses, 61(12), 916-930. https://doi.org/10.1111/myc.12822
Mahmoudi S, et al. Fungal Keratitis: an Overview of Clinical and Laboratory Aspects. Mycoses. 2018;61(12):916-930. PubMed PMID: 29992633.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fungal keratitis: An overview of clinical and laboratory aspects. AU - Mahmoudi,Shahram, AU - Masoomi,Ahmad, AU - Ahmadikia,Kazem, AU - Tabatabaei,Seyed Ali, AU - Soleimani,Mohammad, AU - Rezaie,Sassan, AU - Ghahvechian,Hossein, AU - Banafsheafshan,Ali, Y1 - 2018/07/27/ PY - 2018/04/04/received PY - 2018/06/28/accepted PY - 2018/7/12/pubmed PY - 2019/1/15/medline PY - 2018/7/12/entrez KW - Aspergillus KW - Fusarium KW - corneal ulcer KW - keratitis KW - keratoplasty SP - 916 EP - 930 JF - Mycoses JO - Mycoses VL - 61 IS - 12 N2 - Mycotic keratitis or keratomycosis is a fungal infection with global distribution. The dominant aetiology of this disease varies based on geographical origin, socioeconomic status, and climatic condition. Generally, Aspergillus spp. and Fusarium spp. are common in tropical and subtropical regions and Candida spp. are dominant in temperate areas. Demonstration of fungal elements in microscopic examination besides the isolation of fungi in culture is the gold standard of laboratory diagnosis. As the culture is a time-consuming procedure, other approaches such as in vivo confocal microscopy which produces real-time imaging of corneal tissue and molecular techniques have been developed to facilitate rapid diagnosis of fungal keratitis. The first choice of treatment is topical natamycin, although topical amphotericin B is the best choice for Aspergillus and Candida keratitis. Regarding the diversity of fungal aetiology and the emergence of drug resistance in some genera and species, proper identification using molecular methods and antifungal susceptibility testing could provide useful data. Furthermore, as the better efficacy of combination therapy in comparison to monotherapy is reported, in vitro determination of interactions between various drugs seem informative. This review aims to provide a general and updated view on the aetiology, risk factors, epidemiology, clinical and laboratory diagnosis, and management of fungal keratitis. SN - 1439-0507 UR - https://www.unboundmedicine.com/medline/citation/29992633/Fungal_keratitis:_An_overview_of_clinical_and_laboratory_aspects_ L2 - https://doi.org/10.1111/myc.12822 DB - PRIME DP - Unbound Medicine ER -