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Trichophyton fungal keratitis

Abdulkarim Mohammad1, Abdulaziz Al-Rajhi, Michael D Wagoner

  • 1Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.

Cornea
|December 7, 2005
PubMed
Abstract

Insights

This study details five cases of fungal keratitis caused by Trichophyton schoenleinii, a rare pathogen leading to aggressive corneal disease. Therapeutic penetrating keratoplasty (PKP) offered better visual outcomes in unresponsive cases.

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Fungal keratitis is a significant cause of visual impairment globally.
  • Trichophyton species are uncommon causes of fungal keratitis, often associated with dermatophyte infections.

Observation:

  • Five cases of fungal keratitis caused by Trichophyton schoenleinii were identified.
  • The condition presented with aggressive features, including significant keratolysis due to collagenase production.
  • Clinical sensitivity was noted for topical natamycin, but resistance to amphotericin B and miconazole.

Findings:

  • Medical therapy alone resulted in corneal scarring and poor visual acuity (20/125 to hand motions).
  • Therapeutic penetrating keratoplasty (PKP) achieved clinical cure in two patients with final visual acuity of 20/60 and 20/200.
  • One patient experienced severe complications, including fungal scleritis and panophthalmitis, necessitating enucleation despite multiple PKPs.

Implications:

  • Trichophyton schoenleinii can cause severe fungal keratitis with potential for corneal perforation and intraocular extension.
  • Early diagnosis and prompt treatment, including PKP for medically unresponsive cases, are crucial for managing this rare but aggressive infection.
  • Understanding the organism's drug sensitivities and pathogenic mechanisms is vital for effective treatment strategies.

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