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Liposomal Amphotericin B
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Nenad Macesic, Neil R. H. Stone, John R. Wingard
Fusarium species can cause difficult-to-treat infections, particularly in the immunocompromised, in whom infection can disseminate and become life threatening. Fusarium keratitis is a common cause of fungal keratitis. Susceptibility to AmB in vitro is variable and species dependent (see Chapter 141, Amphotericin B Deoxycholate); however, AmB-based therapies are often used, as there are few effective alternatives. As with many other indications for DAmB, liposomal formulations are preferred where available to minimize the risk of renal toxicity. There are, however, very little data for the use of LAmB in fusariosis, although doses of 3–5 mg/kg/day have been reported to be successful in treating neutropenic patients with Fusarium infections (Nucci et al., 2003). Moreover, a more recent retrospective analysis of 233 cases of invasive fusariosis found a 90-day survival of 53% of patients who were treated with a liposomal formulation of AmB compared to 28% in patients who were given DAmB (Nucci et al., 2014).
Microbial Biofilms
Published in Chaminda Jayampath Seneviratne, Microbial Biofilms, 2017
Chaminda Jayampath Seneviratne, Neha Srivastava, Intekhab Islam, Kelvin Foong and Finbarr Allen
Culture-dependent methodologies have identified P. aeruginosa as the most common pathogen in contact lens–related infections, followed by Serratia marcescens, S. aureus, Acanthamoeba, and Fusarium [90]. Bacterial composition based on 16S ribosomal RNA gene sequencing has revealed that Achromobacter, Stenotrophomonas, and Delftia as the predominant bacteria, showing their role in contact lens–related disease [90]. Moreover, bacterial biofilms may provide binding sites for protozoa such as Acanthamoeba, predisposing lens wearers at increased risk for Acanthamoeba infection if lenses had been previously contaminated with bacterial biofilm [94]. Fungal keratitis is commonly caused by filamentous fungi Fusarium and Aspergillus species and less commonly by yeast-like fungi Candida species [95]. Fusarium adhere to contact lenses and form penetration pegs, which are hyphae of the fungi that traverse into the matrix of lenses. Biofilm on contact lenses can also be mixed species in nature.
Toxicity of simultaneous intrastromal and intracameral injection of voriconazole on corneal endothelium in a rabbit model
Published in Cutaneous and Ocular Toxicology, 2023
Ji Young Moon, Wool Suh, Roo Min Jun, Kyung Eun Han
This study had several limitations. The small sample size and the inclusion of the bilateral eyes of each rabbit might have affected the significance of the results, which should be considered when interpreting the results. Given that rabbit corneal endothelial cells have remarkable regeneration capacity with mitotic activity [48], it should be considered that changes in ECC and CCT might be underestimated since this study investigated the results ≥ 3 days after the procedure. In addition, since cultured hCECs do not regenerate as fast as cultured rabbit corneal endothelial cells [49], it will be necessary to adjust the therapeutic dose in consideration of this in the actual treatment. Furthermore, since this study was based on the results of three repeated injections at intervals of 3–4 days, additional research is needed to determine the toxicity of injections when used at different time intervals and the number of injections. Finally, because this study was conducted only on healthy rabbit eyes, different or opposite outcomes might have been yielded in the diseased eyes. Further studies in eyes with fungal keratitis are needed to support this study’s results.
Post-traumatic Fungal Keratitis and Endophthalmitis Caused by Coniochaeta Hoffmannii with Late Recurrence following Therapeutic Full-thickness Penetrating Keratoplasty
Published in Ocular Immunology and Inflammation, 2023
Waleed Alsarhani, Philip W. Lam, Julianne V. Kus, Corwyn Rowsell, George Kar Tsui, Manal Tadros, Ramzi Fattouh, Yeni Yucel, Peter J. Kertes, Hall F. Chew
Fintelmann et al. reported a case of L. mutabilis keratitis that recurred 6 days after deep anterior lamellar keratoplasty.3 The authors concluded that a full-thickness corneal transplant may have prevented the recurrence of fungal keratitis. Nevertheless, Coniochaeta organisms are resilient and difficult to eradicate. In the current case, C. hoffmannii recurred following a therapeutic full-thickness corneal transplant, albeit recurrence occurred one year later. This may be related to sequestration of C. hoffmannii in the posterior segment as endophthalmitis was previously present. The other possible explanation is biofilm formation in the suture material, a feature of many fungi such as A. fumigatus and C. albicans.14 However, we could not find any studies in the literature that analyzed the ability of C. hoffmannii to produce biofilms.
Current understanding and therapeutic management of contact lens associated sterile corneal infiltrates and microbial keratitis
Published in Clinical and Experimental Optometry, 2021
Lily Ho, Isabelle Jalbert, Kathleen Watt, Alex Hui
Besides a history of exposure to infectious organisms, some clinical signs help to differentiate between bacterial, fungal, and Acanthamoeba infections of the cornea. Fungal keratitis, particularly for those caused by yeast fungi, can be difficult to differentiate from bacterial keratitis as clinical signs may overlap. For example, serrated ulcers and satellite lesions, traditionally thought of as characteristic of fungal keratitis, may also be seen with Pseudomonas aeruginosa keratitis.66–68 Nevertheless, fungal keratitis generally presents in an insidious manner and may take days or weeks before symptoms develop.69 Common features of filamentary keratitis include serrated ulcer margins with raised slough and dry texture infiltrates that are usually white or grey (not yellow) and the presence of satellite lesions.67 Corneal yeast infections tend to present as discrete infiltrates with overlying defects but progress much slower than most bacterial infections.13 Feathery edges and endothelial plaques are other common features of corneal yeast infections.70