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[Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey-comment]
Mustafa Altay Atalay1, Ayşe Nedret Koc
1Erciyes University Faculty of Medicine, Department of Medical Microbiology, Kayseri, Turkey. altayatalay@gmail.com.
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.
Insights
Scedosporium apiospermum causes fungal infections, including keratitis. This fungus is found worldwide in various environments. Previous reports indicate S. apiospermum ocular infections in Turkey before 2013.
Area of Science:
- Mycology
- Ophthalmology
- Infectious Diseases
Background:
- Scedosporium apiospermum is a ubiquitous saprophytic fungus.
- It causes mycetoma and can lead to severe infections in immunocompromised individuals.
- Risk factors for fungal keratitis include ocular trauma, steroid use, and contact lens wear.
Discussion:
- A recent report claimed the first case of Scedosporium apiospermum keratitis in Turkey.
- However, multiple prior ocular infection case reports involving this fungus exist in Turkey since 1989.
- The Kalkan Akçay et al. report is not the first S. apiospermum keratitis case from Turkey.
Key Insights:
- Scedosporium apiospermum is an opportunistic pathogen causing various infections.
- Ocular infections, particularly keratitis, are significant manifestations.
- Accurate citation of previous cases is crucial for scientific literature.
Outlook:
- Correction of the literature regarding the first S. apiospermum keratitis report in Turkey is necessary.
- Further research should acknowledge existing case studies.
- Continued surveillance for S. apiospermum infections is important.
