Federal University of Grande Dourados, Rod. Dourados-Itahum, Km 12, Cidade Universitária, Dourados, Brazil.
Natural & Medical Sciences Research Center, University of Nizwa, Nizwa, Oman.
Mycopathologia. 2024 Aug 7;189(5):74. doi: 10.1007/s11046-024-00874-x.
Mycotic keratitis (MK) represents a corneal infection, with Fusarium species identified as the leading cause. Fusarium is a genus of filamentous fungi commonly found in soil and plants. While many Fusarium species are harmless, some can cause serious infections in humans and animals, particularly Fusarium keratitis, that can lead to severe ocular infections, prevalent cause of monocular blindness in tropical and subtropical regions of the world. Due to its incidence and importance in ophthalmology, we conducted a systematic analysis of clinical cases to increase our understanding of Fusarium keratitis by gathering clinical and demographic data.
To conduct an analysis of Fusarium keratitis, we looked through the literature from the databases PubMed, Embase, Lilacs, and Google Scholar and found 99 papers that, between March 1969 and September 2023, corresponded to 163 cases of Fusarium keratitis.
Our analysis revealed the Fusarium solani species complex as the predominant isolate, with females disproportionately affected by Fusarium keratitis. Notably, contact lens usage emerged as a significant risk factor, implicated in nearly half of cases. Diagnosis primarily relied on culture, while treatment predominantly involved topical natamycin, amphotericin B, and/or voriconazole. Surprisingly, our findings demonstrated a prevalence of cases originating from the United States, suggesting potential underreporting and underestimation of this mycosis in tropical regions. This shows the imperative for heightened vigilance, particularly in underdeveloped regions with substantial agricultural activity, where Fusarium infections may be more prevalent than currently reported.
Our study sheds light on the clinical complexities of Fusarium keratitis and emphasizes the need for further research and surveillance to effectively tackle this vision-threatening condition. Furthermore, a timely identification and early initiation of antifungal treatment appear to be as important as the choice of initial treatment itself.
真菌性角膜炎（MK）是一种角膜感染，其中镰刀菌属被确定为主要病因。镰刀菌属是一种常见于土壤和植物中的丝状真菌。虽然许多镰刀菌属物种是无害的，但有些物种可能会导致人类和动物的严重感染，特别是镰刀菌角膜炎，它可能导致严重的眼部感染，是世界热带和亚热带地区单眼失明的主要原因。由于其在眼科学中的发病率和重要性，我们对临床病例进行了系统分析，以通过收集临床和人口统计学数据来增加对镰刀菌角膜炎的了解。
为了分析镰刀菌角膜炎，我们查阅了 PubMed、Embase、Lilacs 和 Google Scholar 数据库中的文献，共找到 99 篇论文，这些论文涵盖了 1969 年 3 月至 2023 年 9 月期间的 163 例镰刀菌角膜炎病例。
我们的分析显示镰刀菌属 solani 种复合体是主要的分离株，女性受镰刀菌角膜炎的影响不成比例。值得注意的是，隐形眼镜的使用是一个重要的风险因素，近一半的病例与此有关。诊断主要依赖于培养，而治疗主要涉及局部使用纳他霉素、两性霉素 B 和/或伏立康唑。令人惊讶的是，我们的发现表明，来自美国的病例比例较高，这表明在热带地区，这种真菌感染可能存在潜在的漏报和低估。这表明需要提高警惕，特别是在农业活动较多的欠发达地区，那里的镰刀菌感染可能比目前报告的更为普遍。
我们的研究揭示了镰刀菌角膜炎的临床复杂性，并强调需要进一步研究和监测，以有效应对这种威胁视力的疾病。此外，及时识别和早期开始抗真菌治疗似乎与初始治疗的选择同样重要。
