Aspergillus flavus Keratitis: Experience of a Tertiary Eye Clinic in Turkey.
We investigated the clinical and mycological characteristics of four cases of mycotic keratitis caused by Aspergillus flavus that occurred from July 2014 to May 2015 at Çukurova University Hospital, Adana, Turkey. In a 10-month period, a total of 64 corneal smear/scrapings were examined from patients with suspected mycotic keratitis. Fungal cultures were positive in six of these patients, indicating a 9.4% incidence of mycotic keratitis in this region, including four cases of A. flavus and two cases of Fusarium spp. The predisposing factors, clinical presentation, and success of the therapeutic approaches were further evaluated. For all cases, topical voriconazole was the first choice of treatment. Surgical procedures were required to control infection in 3 of the 4 cases, including intrastromal voriconazole injection for two cases and keratoplasty for one case. Predisposing factors included trauma (two cases, 50%), contact lens use (one case, 25%), and previous ocular surgery (one case, 25%). The clinical presentations also differed, including a well-limited ulcer (one case), an ulcer with an irregular feathery margin (one case), and ulcers with satellite lesions (two cases). The mean duration between the time of presentation and definitive diagnosis by culture was 14 days (8-25 days). We observed that A. flavus keratitis can present with different underlying factors and clinical conditions. A combination of antifungal therapy and supportive surgical intervention may resolve infections caused by A. flavus in the cornea.
Department of Ophthalmology, Faculty of Medicine, University of Çukurova, 01380, Adana, Turkey. elif.erdem.1979@gmail.com.
Elif
E
Erdem
Department of Ophthalmology, Faculty of Medicine, University of Çukurova, 01380, Adana, Turkey.
Meltem
M
Yagmur
Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey.
Hazal
H
Boral
Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey.
Macit
M
Ilkit
Department of Ophthalmology, Faculty of Medicine, University of Çukurova, 01380, Adana, Turkey.
Reha
R
Ersoz
Department of Medical Microbiology, Radboud UMC, Nijmegen, The Netherlands.|Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.|Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Seyedmojtaba
S
Seyedmousavi
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D001231:Aspergillus flavus / Q000302:isolation & purification*; D016039:Corneal Transplantation; D003646:Debridement; D005260:Female; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D065819:Voriconazole / Q000627:therapeutic use; D055815:Young Adult
D000935:Antifungal Agents; D065819:Voriconazole
Aspergillus flavus; Mycotic keratitis; Voriconazole