Pseudonectria keratitis-emerging pathogenic fungi in the eye.
Humans
Keratitis
/ microbiology
Antifungal Agents
/ therapeutic use
Eye Infections, Fungal
/ microbiology
Voriconazole
/ therapeutic use
Fusarium
/ isolation & purification
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Itraconazole
/ therapeutic use
Fusariosis
/ drug therapy
Male
Cornea
/ microbiology
Female
Middle Aged
Pseudonectria foliicola
Early identification
Fungal keratitis
ITS sequencing
Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry
Journal
Annals of clinical microbiology and antimicrobials
ISSN: 1476-0711
Titre abrégé: Ann Clin Microbiol Antimicrob
Pays: England
ID NLM: 101152152
Informations de publication
Date de publication:
18 Jul 2024
18 Jul 2024
Historique:
received:
25
04
2024
accepted:
28
06
2024
medline:
19
7
2024
pubmed:
19
7
2024
entrez:
18
7
2024
Statut:
epublish
Résumé
Infectious keratitis, a significant contributor to blindness, with fungal keratitis accounting for nearly half of cases, poses a formidable diagnostic and therapeutic challenge due to its delayed clinical presentation, prolonged culture times, and the limited availability of effective antifungal medications. Furthermore, infections caused by rare fungal strains warrant equal attention in the management of this condition. A case of fungal keratitis was presented, where corneal scraping material culture yielded pink colonies. Lactophenol cotton blue staining revealed distinctive spore formation consistent with the Fusarium species. Further analysis using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) identified the causative agent as Fusarium proliferatum. However, definitive diagnosis of Pseudonectria foliicola infection was confirmed through ITS sequencing. The patient's recovery was achieved with a combination therapy of voriconazole eye drops and itraconazole systemic treatment. Pseudonectria foliicola is a plant pathogenic bacterium that has never been reported in human infections before. Therefore, ophthalmologists should consider Pseudonectria foliicola as a possible cause of fungal keratitis, as early identification and timely treatment can help improve vision in most eyes.
Sections du résumé
BACKGROUND
BACKGROUND
Infectious keratitis, a significant contributor to blindness, with fungal keratitis accounting for nearly half of cases, poses a formidable diagnostic and therapeutic challenge due to its delayed clinical presentation, prolonged culture times, and the limited availability of effective antifungal medications. Furthermore, infections caused by rare fungal strains warrant equal attention in the management of this condition.
CASE PRESENTATION
METHODS
A case of fungal keratitis was presented, where corneal scraping material culture yielded pink colonies. Lactophenol cotton blue staining revealed distinctive spore formation consistent with the Fusarium species. Further analysis using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) identified the causative agent as Fusarium proliferatum. However, definitive diagnosis of Pseudonectria foliicola infection was confirmed through ITS sequencing. The patient's recovery was achieved with a combination therapy of voriconazole eye drops and itraconazole systemic treatment.
CONCLUSION
CONCLUSIONS
Pseudonectria foliicola is a plant pathogenic bacterium that has never been reported in human infections before. Therefore, ophthalmologists should consider Pseudonectria foliicola as a possible cause of fungal keratitis, as early identification and timely treatment can help improve vision in most eyes.
Identifiants
pubmed: 39026348
doi: 10.1186/s12941-024-00723-1
pii: 10.1186/s12941-024-00723-1
doi:
Substances chimiques
Antifungal Agents
0
Voriconazole
JFU09I87TR
Itraconazole
304NUG5GF4
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
64Subventions
Organisme : New Project of Zhejiang Provincial People's Hospital entitled "Construction of Rapid Nucleic Acid Detection Platform for Invasive Fungi"
ID : 20211214
Informations de copyright
© 2024. The Author(s).
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