[Fungal keratitis at the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts: retrospective study of 19 cases].
OBJECTIVE
To report the spectrum of fungal keratitis at the Centre Hospitalier National d'Ophtalmologie XV-XX, Paris.


METHODS
We reviewed 19 cases of fungal keratitis from January 1993 to January 2001. We evaluated the different risk factors, fungal identification, topical and systemic antifungal therapy, surgical treatment and outcome.


RESULTS
Nineteen patients were included, 7 women and 12 men, with visual acuity ranging from 9/10 to no perception of light. The mean age was 56.2 years. Patients were hospitalized for an average stay of 16.3 days and all received a diagnostic and therapeutic scraping and 16 received a local antifungal treatment. The most common risk factors were topical steroid treatment (42.1%), corneal graft (31.6%), trauma or foreign body (31.6%). The mean delay between the first signs and fungal keratitis diagnosis was 14 days. Yeast as Candida parapsilosis and albicans were the most frequently isolated fungi (58%), followed by Aspergillus sp. (21%) and Fusarium sp. (21%). The most commonly used topical treatment was amphotericin B, and itraconazole was used as systemic treatment. Five patients had evisceration, 6 had penetrating keratoplasty and 5 retained leukoma.


CONCLUSIONS
Candida was the most frequently isolated fungi and topical steroid treatment the main risk factor. The prognosis is relatively poor (26% of lost vision) because of a delay in diagnosis and other previous ocular pathology or surgery.
Rondeau
N
N
Service 5, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, 75012, Paris, France.
Bourcier
T
T
Chaumeil
C
C
Borderie
V
V
Touzeau
O
O
Scat
Y
Y
Thomas
F
F
Baudouin
C
C
Nordmann
J-P
JP
Laroche
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D001234:Aspergillus niger / Q000302:isolation & purification; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D016533:Mycological Typing Techniques; D012189:Retrospective Studies; D012441:Saccharomyces cerevisiae / Q000302:isolation & purification; D013997:Time Factors
D000935:Antifungal Agents