Clinical and Mycological Features of Fungal Keratitis: A Retrospective Single-Center Study (2012-2018)
Objectives:To present the demographic, etiological, clinical, and mycological characteristics and treatment results of fungal keratitis patients admitted to our clinic.Materials and Methods:The medical records of patients diagnosed with fungal keratitis between October 2012 and 2018 were reviewed. T...
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| Format: | Article |
| Language: | English |
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Galenos Yayinevi
2022-04-01
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| Series: | Türk Oftalmoloji Dergisi |
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http://www.oftalmoloji.org/archives/archive-detail/article-preview/clinical-and-mycological-features-of-fungal-kerati/51888
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| author | İbrahim İnan Harbiyeli Elif Erdem Nuhkan Görkemli Astan İbayev Hazal Kandemir Arbil Açıkalın Macit İlkit Meltem Yağmur |
| author_facet | İbrahim İnan Harbiyeli Elif Erdem Nuhkan Görkemli Astan İbayev Hazal Kandemir Arbil Açıkalın Macit İlkit Meltem Yağmur |
| author_sort | İbrahim İnan Harbiyeli |
| collection | DOAJ |
| description | Objectives:To present the demographic, etiological, clinical, and mycological characteristics and treatment results of fungal keratitis patients admitted to our clinic.Materials and Methods:The medical records of patients diagnosed with fungal keratitis between October 2012 and 2018 were reviewed. The diagnosis of fungal keratitis was confirmed mycologically and/or cytologically. Treatment response was defined as complete infiltrate resolution and re-epithelization with medical treatment and minor surgical interventions. Patients who underwent penetrating keratoplasty or evisceration due to clinical deterioration despite treatment were classified as treatment nonresponders and were compared with responders in terms of demographic, etiological, and clinical characteristics.Results:Seventy-two (12.8%) of 559 patients diagnosed with microbial keratitis in the 6-year period were fungal keratitis. Of these, 38 cases (38 eyes) without polymicrobial etiology were included in the study. The patients’ mean age was 44.9±19.0 years (range: 2-80) and males predominated (14 females [36.8%], 24 males [63.2%]). Trauma (63.6%) was the most common predisposing factor in patients younger than 40 years old, whereas pathologies impairing ocular surface immunity were the leading risk factor (48.1%) in patients older than 40 years. Filamentous fungi were detected in 34 (89.5%) cases, while yeasts were found in 4 (10.5%) cases. Among 26 cases with positive cultures, Aspergillus species were the most common pathogens (42.3%). Infiltrate size before treatment was larger in nonresponders (14/38, 36.8%) compared to treatment responders (19/38, 50%) (p=0.049). In addition, rates of treatment response were higher in cases in which the infiltrate was located paracentrally compared to other cases (p=0.036).Conclusion:Fungal keratitis is an important public health problem in our region. Ocular trauma is a leading etiology in men under the age of 40 years. In the 6-year period, we observed that the main causes of fungal keratitis were filamentous fungi, and most commonly Aspergillus species. In cases presenting with large and central lesions, aggressive treatment options should be considered and these patients should be followed up more closely. |
| first_indexed | 2024-04-10T10:58:52Z |
| format | Article |
| id | doaj.art-810ca3f97ad3487481635f119b26a576 |
| institution | Directory Open Access Journal |
| issn | 1300-0659 2147-2661 |
| language | English |
| last_indexed | 2024-04-10T10:58:52Z |
| publishDate | 2022-04-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Türk Oftalmoloji Dergisi |
| spelling | doaj.art-810ca3f97ad3487481635f119b26a5762023-02-15T16:19:48ZengGalenos YayineviTürk Oftalmoloji Dergisi1300-06592147-26612022-04-01522758510.4274/tjo.galenos.2021.0951513049054Clinical and Mycological Features of Fungal Keratitis: A Retrospective Single-Center Study (2012-2018)İbrahim İnan Harbiyeli0Elif Erdem1Nuhkan Görkemli2Astan İbayev3Hazal Kandemir4Arbil Açıkalın5Macit İlkit6Meltem Yağmur7 Çukurova Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Adana, Türkiye Çukurova Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Adana, Türkiye Çukurova Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Adana, Türkiye Çukurova Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Adana, Türkiye Çukurova Üniversitesi Tıp Fakültesi, Mikrobiyoloji Anabilim Dalı, Mikoloji Bilim Dalı, Adana, Türkiye Çukurova Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Adana, Türkiye Çukurova Üniversitesi Tıp Fakültesi, Mikrobiyoloji Anabilim Dalı, Mikoloji Bilim Dalı, Adana, Türkiye Çukurova Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Adana, Türkiye Objectives:To present the demographic, etiological, clinical, and mycological characteristics and treatment results of fungal keratitis patients admitted to our clinic.Materials and Methods:The medical records of patients diagnosed with fungal keratitis between October 2012 and 2018 were reviewed. The diagnosis of fungal keratitis was confirmed mycologically and/or cytologically. Treatment response was defined as complete infiltrate resolution and re-epithelization with medical treatment and minor surgical interventions. Patients who underwent penetrating keratoplasty or evisceration due to clinical deterioration despite treatment were classified as treatment nonresponders and were compared with responders in terms of demographic, etiological, and clinical characteristics.Results:Seventy-two (12.8%) of 559 patients diagnosed with microbial keratitis in the 6-year period were fungal keratitis. Of these, 38 cases (38 eyes) without polymicrobial etiology were included in the study. The patients’ mean age was 44.9±19.0 years (range: 2-80) and males predominated (14 females [36.8%], 24 males [63.2%]). Trauma (63.6%) was the most common predisposing factor in patients younger than 40 years old, whereas pathologies impairing ocular surface immunity were the leading risk factor (48.1%) in patients older than 40 years. Filamentous fungi were detected in 34 (89.5%) cases, while yeasts were found in 4 (10.5%) cases. Among 26 cases with positive cultures, Aspergillus species were the most common pathogens (42.3%). Infiltrate size before treatment was larger in nonresponders (14/38, 36.8%) compared to treatment responders (19/38, 50%) (p=0.049). In addition, rates of treatment response were higher in cases in which the infiltrate was located paracentrally compared to other cases (p=0.036).Conclusion:Fungal keratitis is an important public health problem in our region. Ocular trauma is a leading etiology in men under the age of 40 years. In the 6-year period, we observed that the main causes of fungal keratitis were filamentous fungi, and most commonly Aspergillus species. In cases presenting with large and central lesions, aggressive treatment options should be considered and these patients should be followed up more closely. http://www.oftalmoloji.org/archives/archive-detail/article-preview/clinical-and-mycological-features-of-fungal-kerati/51888 aspergilluscandidafusariumfilamentous fungusfungal keratitisyeast fungus |
| spellingShingle | İbrahim İnan Harbiyeli Elif Erdem Nuhkan Görkemli Astan İbayev Hazal Kandemir Arbil Açıkalın Macit İlkit Meltem Yağmur Clinical and Mycological Features of Fungal Keratitis: A Retrospective Single-Center Study (2012-2018) Türk Oftalmoloji Dergisi aspergillus candida fusarium filamentous fungus fungal keratitis yeast fungus |
| title | Clinical and Mycological Features of Fungal Keratitis: A Retrospective Single-Center Study (2012-2018) |
| title_full | Clinical and Mycological Features of Fungal Keratitis: A Retrospective Single-Center Study (2012-2018) |
| title_fullStr | Clinical and Mycological Features of Fungal Keratitis: A Retrospective Single-Center Study (2012-2018) |
| title_full_unstemmed | Clinical and Mycological Features of Fungal Keratitis: A Retrospective Single-Center Study (2012-2018) |
| title_short | Clinical and Mycological Features of Fungal Keratitis: A Retrospective Single-Center Study (2012-2018) |
| title_sort | clinical and mycological features of fungal keratitis a retrospective single center study 2012 2018 |
| topic | aspergillus candida fusarium filamentous fungus fungal keratitis yeast fungus |
| url |
http://www.oftalmoloji.org/archives/archive-detail/article-preview/clinical-and-mycological-features-of-fungal-kerati/51888
|
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