Sherman Amanda B, Clode Alison B, Gilger Brian C
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr, Raleigh, NC, 27607, USA.
Vet Ophthalmol. 2017 Mar;20(2):140-146. doi: 10.1111/vop.12381. Epub 2016 Apr 7.
To determine the significance of Aspergillus and Fusarium spp., as identified by culture, on clinical outcome in equine keratomycosis.
Retrospective analysis of 66 horses (66 eyes) evaluated at the NCSU-VH diagnosed with keratomycosis from which Aspergillus or Fusarium spp. were cultured. Horses were classified into those who improved with medical management alone or those who required surgical intervention to improve. Horses who underwent surgery were divided into globe-sparing procedures or enucleation. Effects of bacterial co-infection, previous topical steroid or antifungal use, and time of year on fungal genus and outcome were evaluated.
Aspergillus spp. was cultured from 41 eyes (63%), while 24 eyes (37%) cultured Fusarium spp. One horse cultured both species and was not included in further evaluation. From the horses that cultured Aspergillus spp., 28 eyes (68%) required surgical intervention to control the infection: 21 (75%) of these eyes maintained globe integrity, while 7 eyes (25%) were enucleated. Of those horses with Fusarium spp., 14 eyes (58%) required surgical intervention: 11 (79%) of these eyes maintained globe integrity, while 3 eyes (21%) were enucleated. Genus of fungus cultured was not significantly associated with the need for surgical intervention nor was it significantly associated with the necessity of globe-sparing surgery versus enucleation. Additionally, bacterial co-infection, previous steroidal or antifungal use, and time of year did not affect outcome or type of fungal species cultured.
Equine keratomycosis from Fusarium spp. compared to keratomycosis from Aspergillus spp. is not associated with a different clinical outcome.
确定通过培养鉴定出的曲霉菌属和镰刀菌属对马角膜真菌病临床结局的意义。
对北卡罗来纳州立大学兽医院评估的66匹患角膜真菌病且培养出曲霉菌属或镰刀菌属的马(66只眼)进行回顾性分析。将马分为仅通过药物治疗改善的和需要手术干预才能改善的。接受手术的马分为保留眼球手术或眼球摘除术。评估细菌合并感染、先前局部使用类固醇或抗真菌药物以及一年中的时间对真菌属和结局的影响。
41只眼(63%)培养出曲霉菌属,24只眼(37%)培养出镰刀菌属。一匹马同时培养出这两种菌,未纳入进一步评估。在培养出曲霉菌属的马中,28只眼(68%)需要手术干预来控制感染:其中21只眼(75%)保持眼球完整,7只眼(25%)被摘除眼球。在培养出镰刀菌属的马中,14只眼(58%)需要手术干预:其中11只眼(79%)保持眼球完整,3只眼(21%)被摘除眼球。培养出的真菌属与手术干预的需求无显著相关性,与保留眼球手术还是眼球摘除术的必要性也无显著相关性。此外,细菌合并感染、先前使用类固醇或抗真菌药物以及一年中的时间均未影响结局或培养出的真菌种类。
与曲霉菌属引起的马角膜真菌病相比,镰刀菌属引起的马角膜真菌病临床结局并无差异。