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Advanced fusarium keratitis progressing to endophthalmitis
Dilek Dursun1, Viviana Fernandez, Darlene Miller
1Department of Opthalmology, Baskent University, School of Medicine, Ankara, Turkey.
Cornea
|June 7, 2003
Summary
Fusarium keratitis can lead to endophthalmitis, a severe intraocular infection. Standard antifungal therapies are often inadequate, necessitating early diagnosis and aggressive treatment for better visual outcomes.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Fusarium keratitis is a serious ocular infection.
- Endophthalmitis is a severe intraocular complication of keratitis.
Purpose of the Study:
- To review the clinical course, treatment, and visual outcomes of keratitis with endophthalmitis caused by Fusarium.
- To assess the effectiveness of current treatment modalities.
Main Methods:
- Retrospective review of 159 Fusarium keratitis cases.
- Analysis of 10 cases with culture-proven endophthalmitis.
- Evaluation of diagnostic methods, antifungal therapies (topical and oral), and surgical interventions.
Main Results:
- Ten of 159 Fusarium keratitis cases progressed to endophthalmitis.
- Fusarium oxysporum and Fusarium solani were the most common species identified.
- Standard combination therapy with oral imidazoles and topical natamycin was often inadequate.
- Surgical interventions including penetrating keratoplasty and enucleation were required in several cases.
Conclusions:
- Aggressive topical antifungal treatment is crucial for keratomycosis.
- Early suspicion and diagnosis of endophthalmitis are vital in non-responsive cases.
- Current combination therapy may be insufficient for severe Fusarium keratitis with intraocular spread.