title: [Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey-comment].
abstract: Scedosporium apiospermum is a saprophytic fungus which is isolated worldwide in soil, fertilizers, polluted water, rotten vegetables, and other natural environments. It is the cause of mycetoma, a subcutaneous infection, characterized by granule formation. It may also cause severe local or diffuse infections in immunosuppressive patients. S.apiospermum-induced arthritis, endocarditis, keratitis, scleritis, endophthalmitis, meningitis, osteomyelitis, otomycosis, onychomycosis, chronic prostatitis, peritonitis, esophagitis, renal infection, and hepatosplenic abscess have been previously reported in the literature. Possible risk factors of fungal keratitis, one of the major causes of fungal ocular infection, include ocular injury, long-term therapy with topical or systemic steroids, immunosuppressive agents, and underlying diseases such as pre-existing corneal surface abnormality and diabetes mellitus, and wearing contact lenses. We paid great attention to the case report presented by Kalkan Akçay E et al. titled "Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey", which was published in the October 2013 issue of Bulletin of Microbiology [Mikrobiyol Bul 2013; 47(4): 727-33]. Although it is deemed as the first case report of S.apiospermum-related fungal keratitis in Turkey, there were several previous case reports of ocular infections associated with this type of fungus in Turkey, including those of Yucel A titled "An eye mycosis caused by Scedosporium apiospermum (Monosporium apiospermum)" published in 1989, Kiratli et al. titled "Scedosporium apiospermum chorioretinitis" in 2001, Saracli et al. titled "Scedosporium apiospermum keratitis treated with itraconazole" in 2003 and Erdem et al. titled "Clinical follow up of a keratomycosis case with total corneal melting" in 2005. In conclusion, it should be highlighted that the report of Kalkan Akcay et al. is not the first case report of Scedosporium apiospermum-related fungal keratitis in Turkey. We believe, hence, that correction of this misinformation would be beneficial for further studies.
authors.affiliation: Erciyes University Faculty of Medicine, Department of Medical Microbiology, Kayseri, Turkey. altayatalay@gmail.com.
authors.forename: Mustafa Altay
authors.initials: MA
authors.lastname: Atalay
authors.forename: Ayşe Nedret
authors.initials: AN
authors.lastname: Koc
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D015821:Eye Infections, Fungal / Q000382:microbiology*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000382:microbiology*; D010866:Natamycin / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D021681:Scedosporium / Q000302:isolation & purification*; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D010866:Natamycin