Successful Management of Pythium insidiosum Keratitis Masquerading as Dematiaceous Fungal Keratitis in an Immunosuppressed Asian Male.

Autor:	Gurnani B; Consultant Cataract, Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India.; Sadguru Chikitsa Netralaya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India., Christy J; Consultant Cataract, Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India., Kaur K; Consultant Cataract, Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India.; Sadguru Chikitsa Netralaya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India., Moutappa F; Consultant Cataract, Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India., Gubert J; Consultant Department of Microbiology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India.
Jazyk:	angličtina
Zdroj:	Ocular immunology and inflammation [Ocul Immunol Inflamm] 2024 Jul; Vol. 32 (5), pp. 583-586. Date of Electronic Publication: 2023 Feb 22.
DOI:	10.1080/09273948.2023.2179495
Abstrakt:	Purpose: To describe the first case of Pythium insidiosum keratitis masquerading as dematiaceous fungal keratitis in a seropositive male. Case Summary: A 44-year-old seropositive male previously treated for acute retinal necrosis presented with pain and defective vision in the right eye following a mud injury 5 days back. Presenting visual acuity was hand movements close to the face. Ocular examination revealed a 7 × 7 mm dense, greyish-white mid stromal infiltrate with pigmentation and few tentacles. The clinical diagnosis suggested fungal keratitis. Corneal scraping on 10% KOH and Gram stain revealed slender, aseptate hyaline hyphae. Before culture results, the patient was treated with topical 5% natamycin and 1% voriconazole, but the infiltrate progressed. Culture on 5% sheep blood agar revealed white fluffy, submerged, shiny, and appressed colonies, and Pythium insidiosum was confirmed by zoospore formation. The patient was further managed with topical linezolid 0.2% hourly, azithromycin 1% hourly, and adjuvant drugs. Conclusion: This is an uncommon presentation of Pythium keratitis masquerading as dematiaceous fungal keratitis in an immunocompromised male.
Databáze:	MEDLINE
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