Fungal keratitis is a time-sensitive ocular infection that often requires a high index of suspicion followed by intensive medical/surgical interventions to achieve a successful clinical outcome. COVID-19 pandemic-related restrictions, necessitated the modification of conventional protocols and guidelines associated with the treatment of keratomycosis. We report four cases of atypical fungal keratitis with poorly differentiated clinical characteristics. The challenges faced during their management were (1) the dilemma of clinically differentiating fungal () and bacterial keratitis; (2) treatment of and keratitis with natamycin monotherapy; (3) mixed infection of and and continuing medications before rescraping the corneal ulcer against the recommended treatment guidelines; (4) phenotypic identification and differentiation among morphologically resembling fungi; and (5) decision making arising out of disparities between KOH and fungal culture results. Three patients responded well to conservative treatments. The fourth patient underwent therapeutic keratoplasty but was lost to follow-up due to travelrelated pandemic restrictions. This case series seeks to broaden the clinician's knowledge of rare and emerging moulds as presumptive aetiologies of keratomycosis. It also intends to emphasize the significance of early microbiological investigations, (direct microscopy and culture), in resource-limited settings, for initiating empirical treatment for a better visual prognosis.
North India experiences an annual outbreak of viral conjunctivitis during the monsoon season, impacting a large number of people, most of whom recover without treatment.
Patients with a history of trabeculectomy (eye surgery for glaucoma) are at increased risk as conjunctivitis can lead to serious complications like blebitis and bacterial/fungal infections.
It's crucial to educate these patients about the conjunctivitis outbreak and the warning signs that require immediate medical attention to prevent complications.
Infectious keratitis is a significant ocular disease that, if left untreated, can lead to blindness. Fungi are among the causative agents that can result in severe symptoms. Keratitis infections are prevalent globally, with a higher incidence reported in tropical and subtropical regions.
College of Veterinary Medicine, Yangzhou University, Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu 225009, China; International Research Laboratory of Prevention and Control of Important Animal Infectious Diseases and Zoonotic Diseases of Jiangsu Higher Education Institutions, Yangzhou University, Yangzhou, China; Joint International Research Laboratory of Agriculture and Agri-product Safety of the Ministry of Education, Yangzhou, Jiangsu 225009, China. Electronic address:
The resistance of pathogenic bacteria to various clinical antibiotics is the major problem in treating bacterial keratitis. Dimethyl fumarate (DMF) has good anti-fungal and anti-inflammatory effects in fungal keratitis, but its effect on bacterial keratitis is unclear. This study aims to investigate DMF's anti-inflammatory and antibacterial effects.
