Management of Filamentous Fungal Keratitis: A Pragmatic Approach.
antifungals
chlorhexidine
fungal keratitis
management
microbial keratitis
microbiology
natamycin
Journal
Journal of fungi (Basel, Switzerland)
ISSN: 2309-608X
Titre abrégé: J Fungi (Basel)
Pays: Switzerland
ID NLM: 101671827
Informations de publication
Date de publication:
11 Oct 2022
11 Oct 2022
Historique:
received:
20
09
2022
revised:
03
10
2022
accepted:
05
10
2022
entrez:
27
10
2022
pubmed:
28
10
2022
medline:
28
10
2022
Statut:
epublish
Résumé
Filamentous fungal infections of the cornea known as filamentous fungal keratitis (FK) are challenging to treat. Topical natamycin 5% is usually first-line treatment following the results of several landmark clinical trials. However, even when treated intensively, infections may progress to corneal perforation. Current topical antifungals are not always effective and are often unavailable. Alternatives topical therapies to natamycin include voriconazole, chlorhexidine, amphotericin B and econazole. Surgical therapy, typically in the form of therapeutic penetrating keratoplasty, may be required for severe cases or following corneal perforation. Alternative treatment strategies such as intrastromal or intracameral injections of antifungals may be used. However, there is often no clear treatment strategy and the evidence to guide therapy is often lacking. This review describes the different treatment options and their evidence and provides a pragmatic approach to the management of fungal keratitis, particularly for clinicians working in tropical, low-resource settings where fungal keratitis is most prevalent.
Identifiants
pubmed: 36294633
pii: jof8101067
doi: 10.3390/jof8101067
pmc: PMC9605596
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Subventions
Organisme : Wellcome Trust
ID : 207472/Z/17/Z
Pays : United Kingdom
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