Toxic non-inflammatory fungal keratitis
Purpose: To report a new entity called “toxic non-inflammatory fungal keratitis.” Methods: Eyes manifesting infective keratitis with a history of prior administration of topical steroids were included in the study. The details pertaining to the type of injury, duration of injury, and primary treatme...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=5;spage=1578;epage=1581;aulast=Subudhi |
| _version_ | 1817975693736148992 |
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| author | Praveen Subudhi Sweta Patro Sabyasachi Pattanayak Prateek Agarwal Silla Sitaram B N R Subudhi |
| author_facet | Praveen Subudhi Sweta Patro Sabyasachi Pattanayak Prateek Agarwal Silla Sitaram B N R Subudhi |
| author_sort | Praveen Subudhi |
| collection | DOAJ |
| description | Purpose: To report a new entity called “toxic non-inflammatory fungal keratitis.” Methods: Eyes manifesting infective keratitis with a history of prior administration of topical steroids were included in the study. The details pertaining to the type of injury, duration of injury, and primary treatment for corneal trauma were meticulously documented. The corneal tissues were scraped from the patients and were analyzed for fungal filaments by using a 10% KOH mount under a compound microscope. Moreover, these scraped materials were plated on blood agar and Sabouraud dextrose agar plates. Results: The corneal ulcers displayed a disproportionately reduced intensity of pain and improved visual acuity. Further, 10% KOH revealed profuse fungal filaments with few inflammatory cells in all the patients. The anterior chamber cells and flare were either reduced or entirely absent. There was no evidence of lid edema and surrounding corneal edema in any of the patients. The mean healing period was 28.8 days (standard deviation (SD): 10.05). The KOH mount revealed the presence of confluent fungal hyphae with a few inflammatory cell infiltrates. The Aspergillus species and Fusarium species were found in 47% and 40% of the cases, respectively. Conclusion: Toxic non-inflammatory fungal keratitis following steroid therapy needs to be considered in fungal ulcers with disproportionately less pain and good visual acuity. The fungal ulcers with altered clinical signs of classical inflammation need to be assessed for topical steroid misuse. |
| first_indexed | 2024-04-13T21:53:19Z |
| format | Article |
| id | doaj.art-f99fc21a578e4aa4ad367b05303a29da |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-04-13T21:53:19Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-f99fc21a578e4aa4ad367b05303a29da2022-12-22T02:28:21ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892022-01-017051578158110.4103/ijo.IJO_2509_21Toxic non-inflammatory fungal keratitisPraveen SubudhiSweta PatroSabyasachi PattanayakPrateek AgarwalSilla SitaramB N R SubudhiPurpose: To report a new entity called “toxic non-inflammatory fungal keratitis.” Methods: Eyes manifesting infective keratitis with a history of prior administration of topical steroids were included in the study. The details pertaining to the type of injury, duration of injury, and primary treatment for corneal trauma were meticulously documented. The corneal tissues were scraped from the patients and were analyzed for fungal filaments by using a 10% KOH mount under a compound microscope. Moreover, these scraped materials were plated on blood agar and Sabouraud dextrose agar plates. Results: The corneal ulcers displayed a disproportionately reduced intensity of pain and improved visual acuity. Further, 10% KOH revealed profuse fungal filaments with few inflammatory cells in all the patients. The anterior chamber cells and flare were either reduced or entirely absent. There was no evidence of lid edema and surrounding corneal edema in any of the patients. The mean healing period was 28.8 days (standard deviation (SD): 10.05). The KOH mount revealed the presence of confluent fungal hyphae with a few inflammatory cell infiltrates. The Aspergillus species and Fusarium species were found in 47% and 40% of the cases, respectively. Conclusion: Toxic non-inflammatory fungal keratitis following steroid therapy needs to be considered in fungal ulcers with disproportionately less pain and good visual acuity. The fungal ulcers with altered clinical signs of classical inflammation need to be assessed for topical steroid misuse.http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=5;spage=1578;epage=1581;aulast=Subudhicorticosteroidsfungal keratitisnon-inflammatory |
| spellingShingle | Praveen Subudhi Sweta Patro Sabyasachi Pattanayak Prateek Agarwal Silla Sitaram B N R Subudhi Toxic non-inflammatory fungal keratitis Indian Journal of Ophthalmology corticosteroids fungal keratitis non-inflammatory |
| title | Toxic non-inflammatory fungal keratitis |
| title_full | Toxic non-inflammatory fungal keratitis |
| title_fullStr | Toxic non-inflammatory fungal keratitis |
| title_full_unstemmed | Toxic non-inflammatory fungal keratitis |
| title_short | Toxic non-inflammatory fungal keratitis |
| title_sort | toxic non inflammatory fungal keratitis |
| topic | corticosteroids fungal keratitis non-inflammatory |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=5;spage=1578;epage=1581;aulast=Subudhi |
| work_keys_str_mv | AT praveensubudhi toxicnoninflammatoryfungalkeratitis AT swetapatro toxicnoninflammatoryfungalkeratitis AT sabyasachipattanayak toxicnoninflammatoryfungalkeratitis AT prateekagarwal toxicnoninflammatoryfungalkeratitis AT sillasitaram toxicnoninflammatoryfungalkeratitis AT bnrsubudhi toxicnoninflammatoryfungalkeratitis |