A 30-year-old Bangladeshi gentleman presented with history of sand entering his left eye and was diagnosed as having fungal keratitis by private ophthalmologist. He was treated with three doses of conventional subconjunctival amphotericin B injections (1.5 mg of amphotericin B and 1.2 mg of deoxycholate) over the inferior bulbar conjunctiva and topical antibiotics. Subsequently, he developed conjunctival necrosis over the site of injections and there was no clinical improvement of the keratitis. He was then treated with intensive antifungal and antibiotics eye drops. Debridement of epithelial plug was done and he was given intracameral amphotericin B injection. There was gradual improvement observed then with conjunctival epithelialization. The conjunctival tissue was completely healed after three months along with the corneal ulcer. Subconjunctival injection of Amphotericin B (AMB) may be considered as an adjunct therapy in severe fungal keratitis to address the issue of compliance. Close monitoring is needed due to its known complication of scleritis, scleral thinning and conjunctival necrosis. Liposomal AMB which is known to cause less toxicity given via subconjunctival injection in human subjects needs to be further studied.
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http://dx.doi.org/10.7759/cureus.5580 | DOI Listing |
Asia Pac J Ophthalmol (Phila)
January 2025
Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan.
Curr Ther Res Clin Exp
December 2024
Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
Background: Immunosuppressive agents like cyclosporine have proven effective in some pediatric cases, although there are limited case reports considering potential risks such as secondary infections.
Objective: This study investigated the safety and efficacy of Cyclosporine A in children who did not respond to high-dose corticosteroids combined with intravenous immunoglobulin (IVIG).
Methods: We reported four pediatric patients diagnosed with toxic epidermal necrolysis (TEN) received treatment at our institution.
Ophthalmol Sci
November 2024
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.
Purpose: The diagnosis of fungal keratitis using potassium hydroxide (KOH) smears of corneal scrapings enables initiation of the correct antimicrobial therapy at the point-of-care but requires time-consuming manual examination and expertise. This study evaluates the efficacy of a deep learning framework, dual stream multiple instance learning (DSMIL), in automating the analysis of whole slide imaging (WSI) of KOH smears for rapid and accurate detection of fungal infections.
Design: Retrospective observational study.
Med Mycol Case Rep
March 2025
Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
A 42-year-old woman was referred to an emergency department. She had an unresponsive corneal ulcer that was initially diagnosed as virus keratitis. Later, the microbiological studies revealed fungal keratitis.
View Article and Find Full Text PDFCornea
January 2025
Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Purpose: To describe a case series of patients with 12 fungal keratitis treated with caspofungin 0.5% eye drops.
Methods: In this study, 12 patients diagnosed with fungal keratitis were treated with topical compounded caspofungin 0.
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